Senior Claims Officer at MUA Kenya

Job Ref. No. MUA05001

Position Summary:

The successful candidate will be responsible for monitoring the performance of claims statistics and behaviors to ensure the quality and accuracy of that data, then process, design, and present it periodically or as requested in ways to help the business make better decisions.

Key Deliverables:

•  Ensure claims are in order through verification of all claim forms submitted by the claimant
•  Ensure all claims submitted are properly registered to avoid duplication
•  Indemnify the policyholder in accordance with the cover available to the individual
• Respond to correspondence on claims
• Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and company policy
• Ensure correct claim costs are reserved
•  Ensure third party recoveries are made
• Analyze claims presented
• Ensure that correct service providers are appointed; loss adjusters, investigators and assessors
• Recommend claims to be approved
•  Issue approval notes or decline notes
• Pay service providers fees
• Follow up for the settlement of relevant claims including the service provider’s fees
• Ensure that claims are processed and paid in a timely and accurate manner
• Follow up on recovery with other parties to make good the claims presented
• Ensure that claims are processed and paid in a timely and accurate manner
• Recommend claims to be settled
• Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis
• Follow-up on various reports to avoid delays in claims settlement
• Ensure customer satisfaction in settlement of claims to avoid disputes
• Resolve complaints/disagreements with service providers amicably so as to maintain a good working relationship
• Respond to correspondence from clients and agents
• Interact with agents and claimants, meet them in person for settlement of claims
• Point out areas for clarification on documentation provided and investigate doubtful entries
• Generate monthly claims recovery reports
• Ensure the accurate and timely preparation and processing of all claims and payment transactions

Requirements:

Applicant should have:

1. Bachelor’s Degree from a recognised University
2. Diploma in Insurance- CII/DIIK at least 5 papers
3. At least 5 years’ experience in the insurance claims handling
4. Good numerical skills
5. Good knowledge of the insurance industry
6. Knowledge of regulations related to the insurance industry