Resolution Insurance Company Ltd is a
general insurer offering innovative and responsive insurance solutions.
We have learned to adapt in this
constantly changing society, and develop comprehensive products that are
relevant to our clients.
The Resolution Insurance brand is
energetic and trendy.
In pursuit of our ambitious growth
plan, we are looking to fill the below position in our General Business
Department.
Senior Claims Analyst
The Senior Claims Analyst’s overall
purpose is to attend to all activities of the claims department in the
processing of insurance claims to achieve prompt, efficient, equitable and
accurate processing and settlement.
Effective claims service is a key
area of opportunity to achieve profitable growth in our market.
The jobholder will be expected to
demonstrate leadership and professionalism and perform all duties in accordance
with the organization’s policies and procedures, keeping in mind the overall
business objectives
Key Outputs
- Ensure that claims are received, registered
and acknowledged in a timely manner and maintain organized claim files.
- Ensure reserving is done and updated upon
receipt of any new information
- Ensure timely and appropriate scanning and
filing of claims records
- Ensure savings on all claims
- Appointment of Service providers up to the
authorized limit in liaison with the Technical Manager and monitor
progress to ensure reports are received promptly
- Maintain good communication with Service
providers and ensure their compliance with set service level agreement
- High level of customer service - ensure Customers
are updated on their claim’s status at all times
- Communicate with intermediaries and direct
clients to obtain information necessary for processing of claims, liaise
with the underwriters, beneficiaries, departments and subsidiary offices
to facilitate claims processing
- Identify risk improvement measures and prepare
suitable interventions and make recommendations to the
management/underwriting department
- To prepare relevant departmental and
management reports for analysis by the 5th of every month including any
emergent risks
- Training of Claims staff on policies, products
and claims processes.
- Any other duties assigned by the Manager.
Qualifications & Experience
Essential
- Diploma in a business related field
- CII/IIK diploma
- At least 5 years relevant experience
- Knowledge of Microsoft Office with excellent
skills in Excel.
Desirable
- Good analytical and problem solving skills.
- Good time management and organizational
skills.
If you believe you are a team player
and would be a valuable resource to this ever growing brand, kindly CLICK HERE to
apply online by COB, Wednesday, 27th May 2015.
Claims Adjudicator
Reporting to the Assistant Claims
Manager, the Claims Adjudicator’s purpose is to ensure that claims are
processed correctly and identify overcharged / fraudulent claims in order to
save the company money.
Key Responsibility Areas:
1) Receive and analyze claims for processing
2) Vet and adjudicate claims for
payment
3) Resolve and reconcile problems
related to claims, by liaising with the providers
4) Escalation of non-resolved issues
to MSP relations within 7 days of initial contact with MSP
5) Prepare the relevant departmental
reports
6) Communicate with clients or MSPs
regarding claims.
Qualifications and Experience:
Essential:
- Diploma in a clinical medicine or Nursing.
- KRCHN or KRN/M Certification.
- At least 3 years relevant experience in health
management.
Desirable
- In-depth knowledge of health management
- Computer skills including knowledge of
Microsoft Office.
If you believe you are a team player
and would be a valuable resource to this ever growing brand, kindly CLICK HERE to
apply online by COB, Wednesday, 27th May 2015.
