The Certified Claims Operations Professional/Manager (CCOP)™/(CCOM)™ certification program is a prestigious and globally recognized qualification designed for professionals seeking to master the operational, technical, and customer service aspects of insurance claims management. In today’s competitive and regulated insurance landscape, claims operations are a critical driver of customer trust, retention, and profitability. This program equips participants with advanced knowledge in claims processing, investigation, adjudication, fraud detection, regulatory compliance, and operational excellence to deliver fast, accurate, and fair claim outcomes.
Claims operations extend far beyond the payment of benefits—they involve complex workflows that integrate policy coverage assessment, loss evaluation, legal and regulatory adherence, fraud prevention, and customer relationship management. Participants will explore strategies for process optimization, automation, and analytics to improve claim turnaround times while maintaining quality and compliance. The curriculum also focuses on building strong customer communication, ensuring transparency, and enhancing service satisfaction throughout the claims lifecycle.
Whether in life, health, general, or specialty insurance, graduates of the CCOP™/CCOM™ program will be equipped to lead operational improvements, manage high-volume claims environments, and adapt to evolving technologies and regulatory frameworks.
Certification Program Objectives:
Upon completing the Certified Claims Operations Professional/Manager (CCOP)™/(CCOM)™ program, participants will be able to:
- Master End-to-End Claims Operations – Understand the full claims lifecycle from notification to settlement.
- Implement Efficient Claims Processing Workflows – Optimize turnaround times while maintaining quality and compliance.
- Strengthen Fraud Detection and Prevention – Use data analytics and investigative techniques to reduce losses.
- Enhance Regulatory and Legal Compliance – Ensure alignment with insurance laws, industry codes, and governance standards.
- Leverage Technology for Claims Excellence – Apply automation, AI, and digital platforms to streamline claims operations.
- Improve Customer Communication and Satisfaction – Build transparent, trust-based relationships with policyholders.
Certification Eligibility Criteria:
To apply for certification from The Operations Management Institute (OMI), candidates must meet the following criteria:
- A Bachelor’s degree from a recognized institution
And/or
- 0–4.9 years relevant experience for Professional level (CCOP)™, or 5+ years for Manager level (CCOM)™.
Note: Applicants who do not hold a Bachelor’s degree but possess exceptional professional experience and hold significant positions within their organizations in a relevant field may also be considered for certification on a case-by-case basis, subject to the approval of the OMI evaluation committee.
Certifying Examination:
- To be certified as CCOP™/CCOM™, student should take up a 1.5 hours online exam conducted by OMI.
- The qualifying exam would consist of 50 multiple choice questions, testing core certification modules.
- Professionals with relevant experience and other qualifying criteria may be exempted from the examination.
Certification Modules:
- Module 1: Fundamentals of Claims Operations and Industry Practices
- Module 2: Claims Intake, Verification, and Coverage Assessment
- Module 3: Investigation, Documentation, and Loss Evaluation
- Module 4: Fraud Detection, Legal Considerations, and Regulatory Compliance
- Module 5: Technology, Automation, and Analytics in Claims Operations
- Module 6: Customer Communication, Dispute Resolution, and Service Excellence
* The Certification Title and its modules are regularly reviewed, updated and may change in alignment with evolving industry needs and regulatory standards.
Who Should Do This Certification:
The CCOP™/CCOM™ certification is ideal for professionals involved in insurance claims operations, including:
- Claims Operations Managers – Overseeing end-to-end claims processes and teams.
- Claims Adjusters and Examiners – Assessing, validating, and finalizing claims.
- Fraud Investigators – Identifying and preventing fraudulent claims.
- Customer Service Leads in Claims – Managing policyholder communication and satisfaction.
- Process Improvement Specialists – Optimizing claims workflows for speed and quality.
- Consultants and Advisors – Supporting claims transformation initiatives.
Key Benefits of CCOP / CCOM Certification:
- Professional Recognition – Establishes your expertise in insurance claims operations.
- Career Growth – Positions you for senior leadership roles in claims management.
- Global Relevance – Skills applicable across multiple insurance sectors worldwide.
- Practical Learning – Case studies and real-world claims handling scenarios.
- Professional Network – Access to a global community of claims and insurance professionals.
- Measurable Impact – Improve claims turnaround, reduce costs, and enhance customer trust.
- Best Practice Alignment – Based on internationally recognized insurance and claims standards.
The CCOP™/CCOM™ certification equips professionals with the tools, techniques, and frameworks to deliver operational excellence in claims management. Whether your goal is to enhance efficiency, improve compliance, or elevate the policyholder experience, this program provides the expertise to achieve it.
