JOB DETAILS:
JOB SUMMARY:
To process claims expeditiously and professionally to meet customer’s expectations and the overall departmental objectives.

ESSENTIAL JOB FUNCTIONS:
• Correspond with clients to acknowledge claim processing and update them on progress regularly.
• Obtaining adequate documents & processing claims within standards of service.
• Timely processing of claims as per the stipulated guidelines and procedures.
• Records, registers, and posts new claims and processes them within the set standards to ensure quality customer service is given.
• Set initial reserves for new claims and recommend reserve changes.
• Close files as payment/recoveries are made.
• Evaluate preliminary claim information and revert to the broker or insured for more information where necessary to ensure that the correct information is documented for ease in processing the claim.
• Cross-check claim details (claim form) and other claim documents with policy specimen copies to ensure accuracy.
• Communicate to the customers through claim acknowledgment, and update to intermediary/insured/claimant on the claim status.
• Liaise with the underwriting department by notifying them of risk improvement issues noted as well as reviewing of policy wordings on areas that need a change in the policies.
• Assist in the determination of settlement amount and issue discharge vouchers for fully documented claims under instructions from the claim’s manager/supervisor.
• Track claims by regularly updating the claims register to determine the progress of the claim.
• Promptly attend to customer’s complaints and inquiries.

EDUCATION, SKILLS AND EXPERIENCE:
• A University degree in Business Administration/BCOM or an equivalent with qualifications in ACII/COP.
• Prior experience as a claims officer in general insurance is mandatory.
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• Excellent computer skills.
• Good Customer service.