Job Description
PURPOSE:
Responsible for effectively handling claims and settling them within stipulated timelines.
PRIMARY RESPONSIBILITIES:
• Register and analyse intimated claims and advise client on supporting claims documents;
• Appoint service providers where applicable;
• Analyse adjuster/ Investigators claim reports to recommend settlement/ approve/ admit;
• Process fully documented claims and referring any suspicious claims to the supervisor;
• Initiate third party recoveries (written demand letters);
• Review claims reserves on a continuous basis in view of new developments and to close files where all payments have been made;
• Process all service providers invoices and payment within the set standards;
• Issue discharge vouchers for all fully documented claims;
• Attend to customer queries and complaints promptly and professionally;
• Follow up on claims payments
Key Skills, Knowledge, Experience and Behavioural Competencies
These are defined as;
Proficiency Level Description
Essential E
Desirable D
Academic and Professional Requirements
Particulars Detail Specific Field or Qualification Need
Type
Education Bachelor’s Degree Bachelor’s Degree in a relevant field, E
Computer literate in MS Office and other office applications E
Part qualification in relevant professional field -Diploma in Insurance,ACCI/AIIK will be an added advantage. D
Experience Required:
Description Required years of experience Need Type
Relevant experience 1 E
Behavioural Competencies
These are defined as:
Proficiency Level Proficiency Definitions
Level 1
Aware (A)
· Applies the competency in the simplest situations.
· Requires close and extensive guidance.
Core Competencies Proficiency Required
1. Customer Focus A
2. Business Acumen A
3. Driving Innovation A
4. Driving Business Performance A
5. Negotiation and Influence A
6. Effective Communication A
Leadership Competency Proficiency Required
1. Planning and organizing A
2. Accountability A
3. Quality Decision Making A
4. Building Partnerships A
5. Continuous Learning A
6. Emotional Intelligence A
7. Conflict Management A
Special Position Requirements ( Optional section: any travel, security, hazard or related special conditions which apply to the position)
· Role holder may be required to work extended working hours to ensure jobs are completed on schedule and to specification.