Senior Account Manager

PURPOSE FOR THE JOB

Working under the supervision of the Head of Claims, a Senior Claims Manager will be a problem solver and is expected to help in creating a conducive environment to deliver an excellent claims experience for better overall client satisfaction.

The person will be involved in handling simple to complex insurance problems in all general insurance classes (other than healthcare & medical) including motor, property, liability, legal, and workman compensation at both personal and commercial lines.

Duties and Responsibilities:

Managing the Client Claims Experience

• Engage, communicate, and manage relationships (client, insurer, claims value-chain partners)
• Offer Claim advice to clients, do claims research, craft, and draft appropriate professional and technical responses to claims issues raised by insurer(s)
• Give the client a competent opinion based on sufficient knowledge of the relevant facts, adequate consideration of the applicable insurance policy, and the claims expert’s own experience and expertise.
• Inform the client as to the policy coverage, exclusions, terms, and conditions that are applicable to their claimed loss and loss circumstances; including the rights, obligations, complaint handling, and dispute resolution mechanism as provided for in the policy.

Manage the Claim cycle

• Guide and advise the client through the entire Adjudication and Claims Processes
• Advocate, represent and champion client’s interest in the claims submitted to the insurer(s), considering the policy wording, insurance industry procedures and evidence in
• the documentation provided
• Responsible for reviewing client claims, applications and adjustments and determining whether a client is covered under their insurance policy and that the claim has been properly adjudicated and processed within reasonable timelines.
• Manage the Insurer service delivery and claims performance
• Liaison and Management of all Claims Value-Chain Service Partners.

Support Claims Department Operations to ensure

• Proper handling and storage of claims documents and client information received during claim shall happen for both the physical and electronic document filing and physical files
• All claims information and data is properly core claims system.
• Implement, ensure adherence, and carry out continuous review and documentation of company ISO and departmental processes to ensure efficiencies in claims diary management, workflow tasks and Issues escalations.
• Preparation of claims Reporting for management purposes with a focus on insurer performance, client performance, staff productivity and policy claims trends.
• Proper management and prompt resolution of complaints emanating during the and out of the claims handling and processing and that no client shall be lost on account of having received a poor claims experience.
• Liaison with the business development and production/retention departments

Key Result Areas:

The accountability areas are as follows;

• Claims closure rate of 115% (closed/new) for the year
• Claims life cycle lead time of 30-60 days (simple claims and 90 - 180 days (large or complex claims)
• Real-time claims Information
• Customer Satisfaction Index of 85% and net promoter score of 60%

Key Competencies:

The job holder must possess competencies and attributes in the following areas:-

• Experience in general Insurance claims of at least 10 years (of which 3years in a similar position) with experience and knowledge of claims handling from all
• general Insurance products, including litigated matters (Experience in a busy Claims Department will be an added advantage)
• Strong Negotiation and Interpersonal Skills and MUST be able to show empathy at all times when handling and dealing with clients
• Ability to interpret insurance contracts and to provide informed advisory and professional opinions to clients and management
• Attention to Detail and Being able to do repeated review and analysis of claim information
• Knowledge about Insurance Industry in general, various insurance products and the Claims practice in particular
• Strong managerial ability and management skills.
• Must be geared towards operational and business excellence.

Knowledge and Skills Required:

The job holder must possess the following:-

• Excellent communicator in both verbal and written English language
• Self-driven and above to work without supervision
• Team player/Team leadership ability
• Excellent computer skills

Academic and Professional Qualifications:

• Bachelor’s Degree from a recognized University (in a business- related/Engineering course)
• A post-graduate Insurance Diploma (AIIK; ACII) and or Associate of the Chartered Institute of Loss Adjusters (ACILA) with passed papers in Advanced Insurance Claims& Insurance Law

Closing: Wednesday, 10, Aug, 2022