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- Registration of all new claims promptly and acknowledging receipt of the same.
- Processing and payment of Individual life, Group Life, Retrenchment, Credit Life claims and benefits.
- Assembling and analyzing claims to establish liability.
- Monitor and ensure that the key interfaces adhere to the set claims handling standards and escalate non adherence to the management.
- Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim.
- Respond to both internal claims inquiries concerning benefits, claims process, service providers, and the filing/completion of proper forms.
- Record all claims transactions and maintain accurate claims registers.
- Continuously review of claim accruals to minimize claim reserves.
- Audit and reporting on potential Unclaimed Assets set to be registered with UFAA
- Capture and maintain accurate data to ensure data integrity.
- Ensure compliance with all regulations.
- Handling customer queries & correspondence on individual life policies to enhance seamless customer experience.
- Prepare claims management reports on a monthly basis or as otherwise advised.
- Facilitating the process of Group & Credit scheme renewals.
- Follow through to ensure all claims with issues at registration level have been addressed or escalated for action.
- Ensure that all claim documents received for Group & Credit Life claims are uploaded and indexed to Document Management System
- Vetting and analyzing Group & Credit claims as per scope of cover whilst ensuring strict adherence to set guidelines and TAT.
- Monthly tracking of insured reimbursement claims with respective underwriters for payment.
- Reconciliation of reimbursement claims and ensuring all the claims are paid within the agreed TAT.
- Perform daily (or weekly) reconciliations and reviews for both financial transactions and LoB Systems.
- Monthly Quality Assurance assessments.
- Notify brokers and clients of pended and declined claims within set timelines.
- Prepare executive presentations and reports to facilitate project evaluation and process improvement.
- Adhere to claims manual procedures and process.
Knowledge, experience and qualifications required
Knowledge, experience and qualifications required:
- Bachelors’ degree in Commerce, Insurance option, Statistics or related courses.
- 0 – 2 years’ experience in claims processing or customer service or financial services.
Technical/ Functional competencies:
- Knowledge of insurance concepts.
- Knowledge of Life insurance claims processes and procedures.
- Knowledge of insurance regulatory requirements.
Leadership category responsibility framework (Core Competencies)
Emerging Leaders in Britam need to:
- Plan, direct and apply efficiencies and resources in order to optimize output and profitability against time, cost and team targets.
- Effectively communicate strategic and operational departmental goals and objectives to peers and others in order to ensure proper implementation.
- Ensure that department priorities are adhered to and effectively communicated.
- Ensure competent and effective people resources through appropriate coaching, development and people supervision as appropriate.
- Embody a high performance, proactive culture.
- Effectively ensure the adherence to key performance areas, deadlines and goals in order to optimize operational effectiveness.
- Effectively communicate resource needs, possible opportunities and achievements to management in order to aid them in their decision-making.
- Effectively set and monitor priorities and objectives for more junior staff.
- Understand and communicate objectives in relation to the larger organisational impact.
- Effectively disseminate knowledge within the correct context, towards subordinates as well as management.
- Appropriately model the company values while setting the pace and energy for delivering.
- Effectively manage and communicate change within the department in order to increase staff and process effectiveness.
- Provide access to accurate and consistent information and services across all channels.
- Ensure a seamless experience for clients.
- Improve service delivery for clients.
- Engage in continuous brand building to become the trusted partners to clients.