The Jobholer will be responsible for supervising the processing of claims in accordance with set standards and guidelines.
The role will report to the Assistant Claims Manager.
Ensure prompt registration and acknowledgement of new claims
Confer with legal counsel on claims requiring litigation
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
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis
Payment of claims within the set service levels
Approval of payment and discharge vouchers within limits
Preparation of claims statistical reports within the stipulated time
Supervise Claims Analysts to ensure that they follow proper methods.
Deliver on performance requirements as defined in the departments’ strategy map, balanced scorecard and Personal Scorecard.
Accountable to the Assistant Claims Manager Directly responsible for staff working under this position Required to liaise and work closely with the other business heads as may be necessary External Relationships:
Knowledge, experience and qualifications required Knowledge, Experience and Qualifications
Bachelors of Commerce degree (insurance option preferred)
Professional qualification in Insurance (ACII/AIIK/FLMI)
Six years successful insurance experience
Technical and functional competencies
Knowledge of insurance industry and concepts
Knowledge of insurance regulatory requirements
Knowledge of claims procedures
Presenting and Communicating Information – Speaks fluently; expresses opinions, information and key points of an argument clearly; presents effectively; responds quickly to others ‘reactions and feedback during conversations; projects credibility.
Working with People – Shows respect for the views and contributions of team members; shows empathy; listens, supports and cares for others; consults others and pro-actively shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
Adhering to Principles and Values – Upholds and encourages ethical behaviour and departmental values; demonstrates integrity; encourages individual responsibility towards the community and the environment; models the organisational values during every day interactions.
Analysing – Analyses numerical data and all other sources of information, breaking them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgements from the available information and analysis; demonstrates an understanding of how one issue may be part of a much larger system / process / problem.
Planning and Organising – Adheres to and monitors clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organises resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
Delivering Results and Meeting Customer Expectations – Focuses on customer needs and satisfaction; sets and models high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic methodical and orderly way; consistently achieves projects goals.