Job Description

Claims Officer-Medical Jobs vacancy in Kenya 2019

Career Employment Claims Officer-Medical Nairobi Kenya May 2019 

Job Description

Key

Accountabilities

Accountability: Operational Process Support

·         Acknowledging new claims and calling for requisite supporting documents/items
·         Registering new claims
·         Ensure that all claims reported are registered in line with the company procedures and reserved accordingly; and also ensure that reserves are periodically reviewed.
·         Ensure that the allocated claims processes are performed within the time frames as agreed with clients, brokers and other departments to ensure service delivery.
·         ·Ensure that service providers fee notes, invoices and Discharge vouchers are settled within the set TATs
·         Assist and manage queries escalated by staff, brokers, clients or service providers to ensure timeous resolution.
·         Liaise and visit brokers to build relationships
·         Assist in the salvages disposal process.
·         Ensure that all the cost containment strategies in claims department are adhered to.
·         Collaborate with underwriting department on areas or actions that may minimize a loss or if action is recommended post a loss due to the risk.
·         Escalate poor performing accounts to Head of claims for management
·         Instructing loss assessors and investigators
·         Examining loss assessment reports and recommending settlement or repudiation
·         Confirming client’s premium payment status
·         Preparing claim settlement offers and discharge vouchers
·         Communicating Risk improvement measures to Underwriting Department
·         Preparing claim payment vouchers for clients and service providers & credit notes
·         Writing cheque forwarding letters and sending them to the dispatch desk
·         Preparing debits for excess and recoveries
·         Writing demand letters
·         Revising reserves
·         Handling facultative recoveries and payments
·         Compiling monthly and annual reports for the IRA and other interested parties
·         Responding to letters and forwarding them to dispatch desk for distribution to clients, intermediaries, service providers and third parties
·         Approving claims settlement within agreed limits (signing authority)
·         Attending to walk in clients and via telephone

Role / Person

Specification

Education and Experience Required:

    Bachelor of Commerce (Insurance Option) degree, or a related business degree, from a reputable university.
    At least 3-5 years’ experience in a busy underwriting or claims department

Professional qualifications

    At least 3 papers and good progress in
    CII Diploma in Insurance (UK)
    IIK Diploma in Insurance (Kenya)

Knowledge & Skills:

    High level of PC literacy (MS Office, Outlook)
    Knowledge of basic financial/accounting concepts
    Excel intermediate
    Basic accounting knowledge
    Negotiation skills
    Organizational skills

Competencies: (Maximum of 8 competencies)

    Personal and Interpersonal skills
     Reporting writing
    Decision making skills
    Relationship and  networking skills
    Persuading and Influencing skills
    Analytical skills
    Ability to work under pressure
    Change management skills

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