Jobs In Kenya : Kenya Orient Job Vacancy for Head Of Claims

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The position is responsible for effectively managing and directing all functions of the Claims Department; including budget, staffing, talent management, staff development and performance management, expense control, quality control and service to both external and internal customers

Responsibilities

Financial

  • Prepare annual budget for the department and ensure proper budgetary control
  • Review analyzed insurance claims to ensure that payments and settlements are made in accordance with company practices and procedures
  • Approve claim payments in a timely manner after confirmation of admissibility
  • Contribute to and enforce the reserving policy in liaison with the actuarial department

Customer

  • Ensure all claims reported are processed expeditiously, within the company’s performance benchmarks
  • Coordinate efforts among staff and other parties to achieve timely, equitable disposition of claims handled in the Claims

Department

  • Resolve complex, severe exposure claims, using high service oriented file handling
  • Comply with customer protocols/service charter

Process

  • Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a sustainable loss ratio
  • In conjunction with GM Operations, establish specific goals for claims handling and develop and implement a tactical plan to support goal attainment relative to productivity, loss ratio, loss and loss adjustment expenses and other agreed upon metrics
  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures
  • Ensure in-depth investigation of claims through direct or indirect contact with policyholders, claimants, physicians, contractors and advocates ensuring that any detected fraud case is handled as per company policy guidelines.
  • Control and direct activities of defense counsel, directly or indirectly through staff
  • Ensure all applicable claims are reported accurately and promptly to reinsurance as required by procedure
  • Ensure compliance with statutory regulatory bodies and serve as lead contact on matters pertaining to claims
  • Analyze claims data to identify issues, and ensure that all relevant issues relating to underwriting policies, re-insurance arrangements, and product pricing are identified and communicated to relevant managers
  • Proactively respond to company and industry trends
  • Develop tools and recommendations for claims risk management/ fraud detection
  • Identify, appoint and maintain an effective panel of claim service providers
  • Prepare periodical claims report and other management reports relating to claims and ensure that any necessary remedial action is taken promptly
  • Any other duties that may be assigned from time to time

Learning and Growth

  • Recruit and motivate employees in line with the organization strategic plans a and ensure compliance with company HR policies/ procedures
  • Facilitate and support talent management, performance management and development
  • Maintain professional and technical knowledge by attending educational workshops and reviewing professional publications.
  • Review, monitor and provide technical expertise to staff and ensure that there is systematic and adequate on job training

Qualifications and requirements

  • A bachelor’s degree from a recognized University.
  • A diploma in Insurance (ACII, AIIK or equivalent)
  • 7 years’ relevant working experience, four (4) of which should have been at Manager level or above

Key Performance

Indicators

  • Competent in prioritizing and working with little supervision, be self-motivated and trustworthy.

Personal attributes

  • People Management: Able to identify, impact and influence others. Able to promote team working with peers, share knowledge and resources with peers and across functions
  • Problem Solving and Decision Making: Ability to make and record effective decisions when they are needed following the appropriate decision making criteria, framework or guidance even if they prove difficult or unpopular
  • Communication skills- Excellent written and verbal communication with a variety of stakeholders including colleagues, business partners, board of directors and regulators
  • Industry Knowledge- A professional/expert in claims handling and management and knowledge of general insurance underwriting
  • Must be well groomed and possess excellent office etiquette.

If you are interested in the position and have the required qualifications, skills and experience, before Monday, June 10th, 2019.

Apply


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