Job Ref. No: JLIL 231
Role Purpose
The role holder will be responsible for efficiently managing and processing claims related to annuities, Income Draw Down (IDD), and ordinary life insurance policies. The role holder will ensure claims are processed accurately, timely, and in compliance with company policies and regulatory requirements, while providing exceptional customer service and maintaining the highest standards of integrity and professionalism.
Main Responsibilities
Strategy
Claims Process Improvement. Identify and implement process improvements to enhance the efficiency and accuracy of claims processing. Develop and refine strategies for handling complex claims, ensuring fair and consistent outcomes. Collaborate with cross-functional teams to streamline workflows and optimize claims operations.
Risk Management. Analyze claims data to identify trends and potential risks. Implement strategies to mitigate fraud and ensure compliance with industry standards and regulations. Recommend changes to policies and procedures based on claims experience and analysis.
Operational
Review, evaluate, and process claims for annuities, IDD, and ordinary life insurance policies.
Ensure claims are processed in accordance with policy terms, company guidelines, and regulatory requirements.
Calculate benefits and payments accurately, ensuring timely disbursement.
Maintain detailed and accurate records of all claims activities and communications.
Ensure all required documentation is complete and compliant with regulatory standards.
Prepare reports on claims activities, outcomes, and trends for management review.
Provide clear and empathetic communication to policyholders, beneficiaries, and other stakeholders regarding claims status, processes, and decisions.
Address and resolve customer inquiries and complaints promptly and effectively.
Educate policyholders on the claims process and required documentation.
Work closely with underwriters, legal teams, and other departments to gather necessary information and resolve complex claims issues.
Liaise with external service providers, such as medical professionals and adjusters, to obtain additional information when needed.
Corporate Governance
Compliance. Ensure all claims handling activities comply with regulatory requirements and internal policies. Stay updated on industry regulations, standards, and best practices related to claims management. Participate in internal and external audits, providing necessary documentation and information.
Policy Adherence. Adhere to company policies and procedures in all claims processing activities. Implement and uphold robust data protection and privacy practices, safeguarding customer information.
Culture
Fostering a corporate culture that promotes ethical practices and good corporate citizenship while maintaining a conducive work environment.
Collaborate with cross-functional teams to develop initiatives that promote a positive and inclusive company culture.
Individualized Development Planning: Create personalized development plans that align with your career aspirations and the organization’s objectives.
Key Competencies
Analytical Skills. Strong analytical skills to assess claims, interpret policy terms, and make informed decisions. Ability to identify trends and potential risks through data analysis.
Attention to Detail. High level of accuracy and attention to detail in claims processing and documentation.
Communication Skills. Excellent verbal and written communication skills, with the ability to convey complex information clearly and empathetically.
Problem-Solving. Effective problem-solving skills to address and resolve claims issues and customer inquiries. Ability to think critically and make sound decisions under pressure.
Organizational Skills. Strong organizational skills to manage multiple claims simultaneously and meet deadlines.
Academic Background & Relevant Qualifications
Bachelor’s degree in Finance, Accounting, Business Administration, or a related field.
Diploma in Insurance qualification will be an added advantage.
LOMA/CII/IIK/ FLMI Qualification will be an added advantage.
Minimum 3 years of experience in life insurance claims management, with a focus on annuities, IDD, and ordinary life insurance claims.
Proven track record of managing and processing complex claims.
Experience in customer service, with the ability to handle sensitive and complex inquiries.
Familiarity with regulatory requirements and industry best practices in claims management.
Experience working in a cross-functional team environment and collaborating with various stakeholders.
go to method of application »
If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position by 6th June 2024. Only shortlisted candidates will be contacted.
Apply via :
Recruitment@jubileekenya.com
