Job Purpose and Key responsibilities
Job purpose
The role holder will be responsible for ensuring that claims are accurately and timely assessed, processed and paid in accordance with company regulations and standards, through provision of guidelines and direction to the staff in the claims section
Key responsibilities
- Ensure prompt registration and acknowledgement of new claims and all claims are processed as per insurance policy in place
- Verify and analyse data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures and ensure no leakages
- Monitor and ensure adherence of all claims set service levels agreement by service providers and claims handlers
- Participate in selection and recruitment of Service providers and ensure all contract and important documents are well documented
- Ensure the timely notification and attendance of queries of all facultative claims
- Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis
- Preparation of monthly claims reports
- Approval of payment, repairs and discharge vouchers within limits
- Participate in review of claim reserves and ensure all are as per the company reserving guidelines
- Supervise & Train Claims Analysts to ensure that they follow company set procedures
- Ensure timely attendance and response to complaints,requlator letters, demand notice, summons
- Compliance with regulatory guidelines Company policies
- Perform any other duties as may be assigned from time to time
Key Performance Measures
- Claims Turn Around Time
- Service Delivery
- Claim Ratio
- Reinsurance Recoveries
- Compliance
- Working Relationships
Internal Relationships:
- Responsible for staff working under this position
- Required to liaise and work closely with the other departments as may be necessary
External Relationships:
- Britam customers
- Insurance sector players
Knowledge, experience and qualifications required
- Bachelors degree (insurance option preferred)
- Professional qualification in Insurance (ACII or equivalent)
- 5 years’ experience in insurance claims processing two of which must be in a supervisory position
- Knowledge and experience in the insurance sector
- Knowledge of Britam products
- The deadline for submitting the application is 30 April 2022.
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