Senior Claims Analyst UIC

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Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

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To process claims expeditiously and professionally to meet customer’s expectations and the overall Company Corporate Objectives.

Responsibilities

• Correspond with clients to acknowledge claim processing and update on progress regularly
• Raise payment requisition vouchers and follow up on cheque preparation progress
• Obtaining adequately documents & processing claims within standards of service
• Review weekly claims reports from AIMS to confirm that all claims have been attended to and reserves adequately maintained. Alert the claims manager all claims.
• Constantly monitor all claims processes and procedures and ensure laid down turnaround time is maintained at all times. Ensure compliance to QOP and ISO 9001 standards
• Assign mails within 24 hours to account handlers and follow up progress to conclusion. Plan and distribute work in the section, monitor and evaluate work performance in accordance with the service standards.
• Monitor appointment and turnaround of service providers and ensure adherence to contract agreement terms and conditions. Maintain a database on all assignments and monitor work progress.
• Ensure fee notes for service providers are processed within the agreed timeline and monitor account reconciliation.
• Arrange quarterly meetings with all service providers to review performance and discuss status of their statements of account.
• Scrutinize and approve settlement offers up to authorized limit. Ensure there is no claim leakage.
• Monitor service levels to clients and ensure frequent updates on claims status are sent out to minimize complaints. Maintain outstanding work within acceptable parameter.
• Ensure all claims reported are handled expeditiously and that valid claims are paid promptly and customers are informed in good time of any potential delays in settlement and/ or repudiations and ex- gratia payments.
• Dealing with counter offers and following up on acceptance of settlement offer.
• Ensure quality output by claims analysts and timely delivery of claims service. Monitor workloads and flows to ensure efficiency.
• Identify staff training needs; ensure that staff in the department are responsible by continuously training on technical and other skills that would broaden their job depth and scope.
• Refer claims with recoveries against third parties to relevant Section for them to ensure that a database is maintained to show expected recoveries and follow up on progress.
• Attend to reinsurance aspects of claims by ensuring that treaty and facultative reinsurers are advised of new claims affecting them, are regularly updated on the progress, and that recoveries are made on all matters within the stipulated period
• Maintain claims settlement costs to a minimum by keeping a database for all settlements made, monitoring fees paid to service providers, and analyzing the costs.
• Monitor and prevent fraud by identifying, recording and advising management of fraudulent cases. Ensure that appropriate action is taken.
• Preparation of other statutory reports and ensure that they are delivered on time. Preparing management reports when necessary and liaising with management, auditors and other authorized third parties on all matters relating to motor claims.
• Preparation of e-gratia request for review by the ex-gratia committee
• Promptly attending to customers complaints and inquiries and ensure that they are resolved amicably. Maintain a record of the complaints and promptly respond to them. Refer to the claims manager if necessary.
• Monitoring reserves for new and for outstanding claims and ensuring that reserves are revised immediately additional information is received.
• Maintain a close working relationship with the underwriting department and alert them on issues that may affect policy cover, policy wordings and or rating and provide material information that can aid them in proactive risk assessment and management. .
• Identify staffing requirements, and liaise with the Claims manager to ensure that competent staff are employed and retained in the property section
• Effectively manage and motivate staff by Planning and defining tasks to be performed, providing guidance, leadership, encouraging and promoting their decision making ability and proactive method of working and Coordinating activities within the unit Monitor workloads and flows to ensure efficiency and maintain systems to quantify output.
• Any other duties that may be assigned by claims manager
• AML: The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and it subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

Skills

Accounting, Accounting, Action Planning, Activity Coordination, Budget Management, Business, Calendar Coordination, Claims Processing, Claims Reporting, Claims Settlement, Computer Literacy, Customer Due Diligence (CDD), Customer Follow-Ups, Customer Service, Data Analysis, Database Reporting, Databasing, Data Compilation, Data Interpretations, Decision Making, Digital Literacy, Due Diligence, Employee Relationships, Enhanced Due Diligence, Ensure Compliance {+ 17 more}

Competencies

Decision QualityDirects WorkEnsures AccountabilityManages ComplexityOptimizes Work ProcessesPlans and AlignsTech Savvy

Education

Advanced Certificate (AdvCert): Insurance (Required), Bachelors Degree (B): Business Administration (Required), Diploma (Dip): Insurance (Required)

Closing Date

28 April 2025 , 23:59

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