Claims Analyst at Heritage Insurance

Job Summary

The role holder will be responsible for processing and payment of general insurance claims in accordance with the set standards and guidelines.

Key Responsibilities

•  Process claims accurately and in a timely fashion as per customer charter and agreed Service Level Agreements
•  Review documents and pertinent requirements regarding an insurance claim to establish liability.
•  Ensure that the insurance claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim.
•  Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim
•  Respond to both internal and external claims inquiries concerning benefits, claims process, service providers, and the filing/completion of proper forms.
•  Record all claims transactions in the system.
•  Track and follow up on receipt of necessary forms.
•  Capture and maintain accurate data to ensure data integrity.
•  Prepare weekly, monthly and quarterly reports and any other ad hoc reports as may be required by management.
•  Issue release letters
•  Issue authority letters for windscreen fitting and car hire.
•  Maintain a diary system for all active files.
•  Review files for continuing adequacy of reserves
•  Handle routine correspondences.
•  Maintain a high level of service to customers at all points of contact such as telephone calls, emails letters or personal visits.
•  Prompt attention to complaints
•  Appoint service providers such as assessors, investigators and loss adjusters Issuance of release letters upon completion of repairs and submission of documents.
•  Issuance of discharge vouchers
•  Proper adjustment of claims to avoid overpayment.
•  Cross check claims information with IMIDS data system for fraud detection
•  Investigate claims that appear to be suspicious.
•  Enforce SLAs with service providers.
•  Ensure policy excess is collected and apply depreciation where applicable.
• Settle payments via EFT to cut down on cheque processing costs.

Qualifications

• Bachelor’s degree in insurance, Economics or other business related discipline
• Progress towards Diploma in Insurance (ACII or AIIK), (at least 3 papers or equivalent)

Experience

•  2 years’ experience in claims management

Competencies

•  Understanding of insurance operations and concepts
•  Knowledge of insurance regulatory requirements
•  Knowledge of claims procedures
•  Excellent organizational and stakeholder management skills