Claims Manager at Kenya Orient Insurance Limited

Claims Manager Jobs Responsibilities

• In liaison with the MD formulating and monitoring the claims Department strategic plans
• Recruit and motivate employees in line with the organization strategic plans a and ensure compliance with company HR policies/ procedures
• Facilitate and support talent management, performance management and development
• Build a supportive, team-orientated environment for the staff through embodying a sense of empowerment, demonstrating positive thinking and establishing common goals and interdependence with the employees.
• Ensure in-depth, investigation of actual claims through direct or indirect contact with policyholders, claimants, other carriers, physicians, contractors, attorneys ensuring that any detected fraud case is handled as per company policy guidelines.
• Control and direct activities of defense counsel, directly or indirectly through staff
• Ensure all applicable claims are reported accurately and timely to reinsurance as required by procedure.
• Co-ordinate and maintain expeditious and efficient processing of claims and ensure customer needs are attended to promptly.
• Ensure compliance with statutory regulatory bodies
• Prepare annual budget for the department and ensure proper budgetary control.
• Analyse claims data to identify issues, and ensure that all relevant issues relating to underwriting policies, re-insurance arrangements, and product pricing are identified and
  communicated to relevant manager.
• Set standards (benchmarks) for measuring the performance of strategic customer relationship and communication.
• Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures.
• Confer with legal counsel on claims requiring litigation.
• Develop tools and recommendations for risk management / fraud detection
• Ensure that all claims fall within scope of respective insurance policy.
• Coordinating the preparation of weekly claims statistics.
• Control administrative costs through effective budgeting, appropriate staffing and close monitoring of ongoing expense allocations.
• Identify, appoint and maintain an efficient and effective evaluation of service providers.
• Prepare periodical claims report and other management reports relating to claims and ensure that remedial action is taken promptly
• Set reserves on files and distributed reserve and settlement authority to claims staff within corporate guidelines.
• Any other duties that may be assigned by the MD from time to time.

Qualifications for the Claim Manager Job

• A bachelor’s degree from a recognized University.
• A diploma in Insurance (ACII, AIIK or equivalent)
• Master’s Degree
• 8 years’ relevant working experience, four (4) of which should have been at Section Head level or above
• Analytical Thinking
• Customer orientation
• Holding People accountable
• Leadership and developing others
• Relationship building for influence
• Team working
• Innovation