The Claims Administrator is responsible for assessing, registering corporate claims, acknowledging, and making recommendations or approvals in line with the Authorization framework and Service Level Agreements (SLAs).
Key Primary Responsibilities
Assessing, registering corporate claims, acknowledging and making recommendations or approvals in line with the Authorization framework & Service Levels Agreements (SLA’s).
Following up with finance on all claims settled for quick disbursement of claims funds.
Reviewing claims documents & reports and making suitable recommendations.
Communicating claims decisions to clients and Brokers as per the TAT’s.
Reviewing claims outstanding, engaging clients and Brokers on outstanding claims documents.
Attending to clients/Brokers by ensuring their claims issues/concerns are addressed within turnaround time (TAT’s) and SLA’s in place.
Performing monthly reconciliation and sign off with Finance on settled claims.
Strict adherence to customer charter, compliance issues by working and collaborating with Customer service teams, Risk, Audit, AKI and the Regulators.
Monitoring & maintaining accurate records and up to date claims records both physical and in LMS.
Safekeeping and proper use of all company documents, records and moveable assets assigned to the Team.
Preparing and providing monthly claim reports on claims reported, settled, declined and closed.
Registering and resolving customer’s complaints within the timelines provided.
Generic Duties
Participating in company CSR and brand building activities in liaison with other departments.
Attending to all internal and external trainings as advised.
Attending Operation activities as advised from time to time.
Academic & Professional Qualifications
Bachelor degree in Insurance/Actuarial Science or an equivalent.
Completion of, or good progress towards, the CII/IIK Diploma (with at least four (4) Diploma papers passed) will be an added advantage.
