Primary Responsibilities
- Assessing, registering claims, acknowledging and making recommendations or approvals in line with the Authorization framework & Service Levels Agreements(SLA’s).
- Following up with finance on all claims settled for quick disbursement of claims funds.
- Reviewing claims documents & reports and making suitable recommendations.
- Preparing claims files notes, organizing claims committee meeting meetings.
- Communicating claims decisions to clients and Brokers as per the TAT’s.
- Liaising with reinsurers and other service provider on complex claims.
- Performing reinsurance recovery for claims settled.
- Making recommendations for investigation for all suspicious claims.
- Providing input to business development and underwriting on how to improve products and processes.
- Reviewing claims outstanding, engaging clients and Brokers on outstanding claims documents.
- Attending to clients/Brokers by ensuring their claims issues/concerns are addressed within turnaround time(TAT’s) and SLA’s in place.
- Improving and enhancing core system to improve automation and digitization;
- Reviewing of claims process manual;
- Participating fully in all quality processes improvement, including ISO;
- Performing monthly reconciliation and sign off with Finance on settled claims.
- Strict adherence to customer charter, compliance issues by working and collaborating with Customer service teams, Risk, Audit, AKI and the Regulators.
- Monitoring & maintaining accurate records and up to date claims records both physical and in LMS
- Safe keeping and proper use of all company documents, records and moveable assets assigned to the Team.
- Providing management with the necessary claims reports and confidential reports on claims matters;
- Attending to all client’s/Brokers complaints until successfully resolved.
Generic Duties
- Preparing and monitor monthly and annual budgets for the respective teams through weekly, monthly and quarterly production reports and targets.
- Entrenching performance based appraisal of staff in line with their set KPIs and departmental targets.
- Participating in company CSR and brand building activities in liaison with other departments
Academic Qualifications
- Bachelor’s degree in Insurance/Actuarial Science or an equivalent.
Skills
- Leadership skills
- Negotiation Skills
- Time management skills
- Good negotiation skills
- Underwriting skills
- Interpersonal and Communication skills
Professional Qualiofications
- Diploma in CII/IIK
Experience
- At least 6 years’ relevant experience.
How to Apply
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