Job Description
DUTIES AND RESPONSIBILITIES
• To be the single point of contact for the company on claims and manage the claims resolution process.
• Oversee the intake and processing of insurance claims for all classes of business loss based on coverage, appraisal and verifiable damage.
• Determining and delegating claims settlement authorization within the company
• Provide technical guidance to staff on claim investigation, reserving evaluation and resolution of claims.
• Conduct audits of the claims process with a view to improving efficiency and participant experience.
• Completes field re-inspections of vendor or employee claims to ensure proper claim handling and compliance with company procedures.
• Assists in the coordination of third-party service providers in all claims processes.
• Participates in training and/or mentoring of departmental staff
• Develops, analyzes and reports KPIs useful in measuring team performance as well as the effectiveness of the claim’s operations.
• To maintain a verifiable claims register.
• Coaching and mentoring Claims team members to improve participant experience and practices for claim quality assurance.
• Report to CEO on service standards and compliance requirements with IRA
• Review complex claims cases with a view of resolving them amicably.
Management Responsibilities
• To be responsible for the set-up, management, and coordination of the claims department.
• Supervise & review the performance of the Claims Department and other administrative matters within the department.
• To be responsible for the coordination of outsourced specialists.
• To report to the CEO and the Board on claims management performance.
• Participate in the review of SLA agreements with 3rd Party providers.
QUALIFICATION, EXPERIENCE, AND SKILLS
Minimum Qualifications:
• Bachelor’s degree in any business-related field.
• Excellent reporting skills.
Experience:
• Minimum of Six (6) years of work experience
• 3 years of working experience in a similar role.