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Corporate Document and Data Operations Associate-(2200000M)

Key Responsibilities

  1. Ensure client details/ instructions are accurately and timely processed in line with the requisite processes 
  2. Process all reimbursements as per SLA
  3. Process all endorsements  as per SLA
  4. Process all policies new and renewal as per SLA
  5. Process all claims from service providers as per SLA
  6. Process all reconciliation service provider invoices are reviewed and shared as per SLA 
  7. Co-ordinate any out-sourced services of document storage and retrieval
  8. Accurate and timely processing of client requests
  9. Manage escalation reports of recurrent issues vis-à-vis agreed Service Level Agreements.
  10. Escalate quality issues to Operations manager for management.
  11. Implement the customer experience strategy in the respective business divisions
  12. Investigate and respond to all internal and external customer enquiries promptly.
  13. Process all approved underwriting policies and claims processing within the provided SLA’s 
  14. Escalate complex queries to the appropriate functional area
  15. Maintain regular internal (to staff) and external (to customers) communication on Customer Service matters.
  16. Investigate and respond to all customer enquiries promptly.
  17. Carry out customer and product related document processing
  18. Respond to customer queries in a professional manner
  19. Make customers’ experiences better by ensuring customer satisfaction
  20. Ensure high standards of Customer Service are maintained in all at level

Knowledge, experience and qualifications required

Knowledge, experience and qualifications required

  • Bachelor’s degree in a business related field
  • At least 2- 4 years’ experience in a similar position
  • Computer Literate; emphasis on Microsoft Office and EDMS

Commercial Motor Claims Associate  (2200000N)

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Key responsibilities

 Ensure prompt registration and acknowledgment of new claims upon receipt of notification.

2.    Evaluate and settle claims, to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio

3.    Confer with legal counsel on claims requiring litigation and defense in courts

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4.    Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures

5.    Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis such as ex-gratia & declines

6.    Processing of claims within the set service levels agreements for excellent customer service

7.    Preparation of weekly & monthly claims reports to the team leader upon request.

8.    Portfolio analysis and risk recommendation to the underwriting department upon analysis of trends in motor claims.

9.    Recommendation for approval of payment and discharge vouchers within limits.

10. Oversee the preparation of claims statistical reports within the stipulated time.

11. Delegated Authority:  As per the approved Delegated Authority Matrix

12. Initiate and pursue recovery of claims from insurers of negligent partners by ensuring demand letters are send out, filed and TP register is updated

13. Retrieve, document, and pursue facultative claims 

14. Prompt settlement of garage invoices to save on early payment discount

15. Negotiate fees with other service providers to save on costs

16. Maintain adequate initial reserves as per reserve guidelines and participate in the monthly, quarterly and annual reserves reviews

17. Shoulder TLs & other managers in client’s meetings

18. Ensure prompt disposal of motor salvages to stop storage charges accruing – Rotational basis

19. Perform any other duties as may be assigned from time to time

Knowledge, experience and qualifications required

Bachelors of degree Actuarial or Applied Statistics

2.    Progress in professional qualification in Insurance (ACII, FLMI or AIIK)

3.    2-3 years’ experience in insurance claims processing

4.  Data analytics experience added advantage

5.  Knowledge and experience in the insurance sector

Corporate Care Management Associate(2200000O)

Key responsibilities

  • Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration)
  • Interact with clients and service providers to ensure that the care is given within policy guidelines
  • Review medical reports and claims for compliance with set guidelines
  • Liaise with underwriters on scope of cover for the various schemes
  • Ensure that medical scheme members are attended to round the clock with support from 24 hour call centre.
  • Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
  • Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
  • Delegated Authority:  As per the approved Delegated Authority Matrix
  • Prepare periodic reports for management on medical claims
  • Ensure claims are processed within the stipulated time 
  • Perform any other duties as may be assigned from time to time

Key Performance Measures

  • As described in your Personal Score Card

Knowledge, experience and qualifications required

Knowledge, experience and qualifications required

  • Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
  • Moderate understanding of insurance concepts
  • Professional qualification in FLMI, ACII and IIK.
  • 5-8 years’ experience in case management two of which should be in a supervisory position

Associate– Customer Retention & Self-service(2200000H)

  • Coordinate and work with the various; sales, marketing, product development and operations teams to drive and increase customer retention.
  • Support in  all customer self-service initiatives and uptake for the Retail Business Unit / Segment and work with the Branches and Distribution Network to drive the increased use of Self-Service channels by customers.
  • Support in developmenting, reviewing and implementing all the processes and procedures required to achieve the goals and objectives with respect to both customer retention and customer self-service adoption.  
  • Work with various stakeholders to design and implement proactive customer retention initiatives that are supported with robust research and/or data analytics.
  • Work with the various operations teams to ensure that all service requests received through self-service channels are executed correctly and as per the agreed TATs.
  • Work with the Forensics Department to quickly investigate and conclude on fraud related cases that have a direct impact on Retail Customers.
  • Coordinate and work with various stakeholders across Britam to ensure that all customer complaints escalated through the Regulators i.e Insurance Regulatory Authority (IRA), Retirement Benefits Authority (RBA) and Capital Markets Authority (CMA) are resolved.
  • Provide support and be an intermediary link between the life business and the regulator (IRA) on customer service issues relating to Life business.
  •  Maintain and document resolved complaints reported for the retail business from the IRA in the Customer relationship management system (CRM).
  • Coordination of follow-up and monitoring of uncollected benefits to reduce the exposure related to returns to unclaimed Financial Assets Authority.
  • Coordinating with the treasury team for provision of the fund performance commentary for the unit linked products in the retail business unit in particular the Imarika fund as required.
  • Prepare and submit to management weekly dashboards and monthly reports (with robust analysis of the key issues and generate useful insights for management action) with respect to business performance in the areas of customer retention and self-service.
  • Prepare and submit business case escalations and ex gratia cases.

Key Performance Measures

  • Sign-Up on Self-Service Platforms (i.e. Online Portal & Mobile App)
  • 2021, 2020 and 2019 Policy Retention Rates for Retail Life Insurance Business
  • Retention Rate for Retail General Insurance Business
  • Process Digitization & Automation
  • Conservation of surrendered & cancelled policies
  • Audit, Risk & Compliance Issues
  • Weekly/Monthly Business Performance Reports

Knowledge, experience and qualifications required

Knowledge, experience and qualifications required

  •  Bachelor’s degree in a business related field
  • At least 1 years’ experience in a similar position

Retail Customer Experience Associate-Medical (1 year Fixed Term Contract)(2200000G)

  • Drive progress towards the goal to reduce operational costs and increase total number of customers via retention by answering calls in a professional and informative manner.
  • Handling customer queries, complaints, instructions received through call and email communication 24/7.
  • Interact with clients, intermediaries, and service providers to ensure that the care is given within policy guidelines.
  • Adherence to admission and discharge protocol i.e. claim reserve, initial authorized cost, cover benefits and duration.
  • Respond to queries from clients, intermediaries, and service providers through answering telephone calls, interviewing clients, and verifying information as well as liaise with underwriters on the scope of cover for the various schemes benefits.
  •  Prepare periodic care reports for management on medical matters/ issues;
  • Maintain and improve quality results by adhering to standards and Customer Experience guidelines,recommending improved procedures with a QA score target 90%,NPS +30, CSAT 90%.Customer Effort 90%.
  •  Ensure clients outpatient approvals are issued via email as per SLA .
  • Maintains communication equipment by logging in 90% of interactions through CRM for traceability / visibility;
  • Perform any other duties as may be assigned from time to time.

Knowledge, experience and qualifications required

Knowledge, experience and qualifications required

  • University degree in a social science or business related field.
  • At least 2-3 years’ experience in a contact center


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