The Corporate Account Specialist is accountable for the end-to-end fulfilment and servicing of assigned group insurance accounts, with emphasis on complex, non-standard, high-risk, and time-sensitive transactions. The role applies broad operational knowledge across policy administration, underwriting, claims, billing, reinsurance, compliance, and distribution processes to assess issues, exercise judgment within delegated authority, and recommend or implement appropriate resolutions. The Specialist serves as a subject matter resource for fulfilment processes, provides guidance to internal and external stakeholders, provides continuous-improvement initiatives, and develops or strengthens operating standards, controls, and service practices that improve accuracy, turnaround time, client experience, and risk management.
Position Responsibilities:
1.Policy Administration & Account Fulfillment
Own the end-to-end servicing of assigned corporate accounts, including member movements, beneficiary updates, coverage changes, policy reinstatement, Certificates of Insurance or Coverage, active-member records, No Evidence Limit letters, and Group Credit Life reconciliation.
Assess complex or non-standard requests, identify policy, underwriting, billing, claims, compliance, or data implications, and determine the appropriate course of action within approved guidelines and delegated authority.
Provides resolution to exceptions, discrepancies, ageing items, and escalated service issues; coordinate root-cause analysis, document decisions, and ensure closure within agreed service levels.
Perform quality and risk checks on high-impact transactions and initiate corrective or preventive actions when control gaps are identified.
2. Claims, Underwriting, Experience Refund Management
Prepare and submit complex member underwriting cases, Letters of Authorization, reinsurance reports, concentration-risk reports, Annual New Premium or other required management and regulatory reports.
Validate member eligibility for claims and coordinate resolution of coverage or record discrepancies that may affect claim assessment.
Review and process experience refunds, premium refunds, and Annual Premium Equivalent increments, ensuring accuracy, approvals, and audit trail.
Analyze recurring discrepancies, and service trends and recommend risk-mitigation or process changes.
3. Guidance and Distributor Management
Provide professional guidance to Distribution Partners, clients, brokers, bancassurance and agency contacts, and internal teams on fulfilment requirements, policy provisions, process options, and resolution pathways.
Coordinate complex cases across Underwriting, Claims, Sales, Middle Office, Compliance, and other support teams, clarifying accountabilities, dependencies, and required decisions.
Handle sensitive inquiries and complaints, balance client needs with policy and control requirements, and escalate matters that exceed delegated authority with a clear assessment and recommendation.
Act as a subject matter resource for assigned processes and provide functional coaching, case consultation, and knowledge transfer to less experienced team members.
4. Standards, Controls and Continuous Improvement
Co-lead process reviews and improvement initiatives affecting fulfilment operations, including simplification, automation thru the use of AI, control enhancement, service-level improvement, and reduction of manual errors or rework.
Develop, maintain, and recommend updates to standard operating procedures, job aids, checklists, templates, decision guides, and quality-control standards.
Use operational data and case trends to identify root causes, quantify impact, propose solutions, and monitor whether implemented actions deliver the intended results.
Participate as a fulfilment subject matter representative in system enhancements, user acceptance testing, operational-readiness activities, and implementation of regulatory requirement.
5. Risk, Compliance and Service…