Claims Analyst at Resolution Insurance

Reporting to the Claims Manager, the job holder’s role will be to timely and correctly process claims ensuring cost containment and adherence to company policies.

Attending to all activities of the claims department in the processing of insurance claims to achieve prompt, efficient, equitable and accurate processing and settlement.

Key Responsibility Areas:

• Ensure that claims notified are covered in terms of the Policy issued and that they are registered promptly
• Enter new claims on computer system Management Information System (MIS), in a timely manner
• Analyze claims supporting documents to establish liability
• Communicate with intermediaries and direct clients to obtain information necessary for processing of claims, Liaise with the underwriters, beneficiaries, departments and subsidiary offices to facilitate claims processing
• Appointment of Assessors/Investigators/Doctors up to the authorized limit in liaison with the Claims Manager and monitor progress and ensure reports are received promptly
• Identify risk improvement measures and prepare suitable interventions and make recommendations to the management
• Adjust and maintain correct claim reserves
• Maintain a register of claims to be recovered
• Initiate recovery from negligent third parties and promptly hand file to Legal Section.
• Attend to client queries on claims
• To prepare relevant departmental and management reports for analysis by the 5th of every month
• Fulfill further duties which may be required in addition to the above

Knowledge & Experience Required

• Bachelor’s Degree in a business related field.
• At least 2 years’ experience in Claim processing.
• Professional Qualification in Insurance (ACII, AIIK)
• Knowledge of General Insurance claims procedures, processes and the regulatory environment.

Desirable

• Good analytical and problem solving skills.
• Good time management and organizational skills
• Ability to build relationships and customer focus