Careers at Britam

Job Purpose:

• Control and managing of the policy cycle through pre-authorization and case management, to ensure quality and cost effective care.

Key responsibilities:

• Ensure all received claims are vetted and released to finance on time (Credit and reimbursement claims).
• Set the appropriate parameters for each admission and claims for IP and OP (claim reserve, initial authorized cost and duration).
• Interact with clients and service providers to ensure that the care is given within policy guidelines.
• Review medical reports and claims for compliance with set guidelines.
• Liaise with underwriters on scope of cover for the various schemes.
• Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
• Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
• Prepare periodic reports for management on medical claims.
• Ensure claims are processed within the stipulated time.
• Delegated Authority: As per the approved Delegated Authority Matrix.

Key Performance Measures:
As described in your Personal Score Card.

Knowledge, experience and qualifications required

• Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
• Moderate understanding of insurance concepts.
• Professional qualification in FLMI, ACII and IIK.
• 5-8 years’ experience in case management two of which should be in a supervisory position.

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Job Purpose:

• The job holder will be responsible for ensuring effective administration of Group Life and Credit Life business through operational excellence and intermediary relationship management.
• Assist the Assistants/Officers to meet the set SLAs and TATs by providing basic guidance on processes and procedures.

Key responsibilities:

• Business Retention & Growth - Ensure retention by providing superior services, regular client visits and attending scheme renewal meetings to advise clients on cover enhancements.
• Relationship Management - Building strong and effective business relationships with our existing clients/intermediaries. Support collaboration with internal and external partners.
• Scheme Compliance - Ensuring all schemes are on-boarded, administered and managed in full compliance with existing legislation and internal processes and procedures.
• Risk and Compliance - Ensure compliance to procedures and processes.
• Credit Control - Participate in credit control meetings and assist in resolution of matters raised in the credit control meeting.
• Trainer and Subject Matter Expert - Serve as a subject matter expert and trainer to newly recruited Life Servicing Assistants.
• Member Education - Assist in planning member education and sensitization activities and initiatives.
• Reconciliation - Reconcile and prepare statements for assigned financial accounts and forward the same for approval to the Corporate Life Servicing Manager.
• Intermediary Management - Perform intermediary on boarding, prepare SLAs, ISAs and IPSAs and ensure sign of all intermediary related documents.
• Premium Collection - Manage premium collection and refund procedures for lost accounts. Monitor premium arrears for policy movements and share reports with Sales and Finance.
• Administration of combined solutions i.e. Group Life & GPA/WIBA policies.
• Generate and dispatch periodic customer statements.
• Prompt handling of queries from intermediaries and direct clients.
• Prepare reports as and when required.
• Delegated Authority: As per the approved Delegated Authority Matrix.

Key Performance Measures:
As described in your Personal Score Card.

Knowledge, experience and qualifications required

• Bachelor’s degree in a business-related field. 
• Professional studies in insurance – AIIK or ACII.
• 3-6 years’ experience in a busy insurance company.

Technical/ Functional competencies:

• Knowledge of group life service operations. 
• Knowledge of insurance industry and concepts. 
• Planning and organization skills.