Summary
Date Posted: Thursday, October 07, 2021 , Base Salary: Not Disclosed

JOB DETAILS:

Job Purpose
The Claims Manager will oversee the claims department to ensure that the company is completing appropriate investigations within the letter of the law. Be detail-oriented and able to spot the subtle details that may indicate intentional fraud or otherwise false information. Take the lead in handling customer disputes, working on complex cases, and determining revenue goals based on past performance.

Summary of Key Responsibilities:
• Design and implement various policies and procedures for claims.
• Provide services to all business requirements and ensure optimal handling of all claims and investigate all issues and provide training for all business units.
• Act as a member of, coordinate and lead the Underwriting Committee and Claims and Reserving Committee.
• Evaluate all new claims and administer all data integrity data and manage communication to the safety department and monitor all claims exceeding set limits and ensure timely closure.
• Evaluate all business units associate claims.
• Schedule all internal and external audits on all claims issues and supervise the processing of all billing issues.
• Liaise with brokers, underwriters and legal advisers (when necessary) to understand detailed clauses within contracts written and claims developing.
• Provide training to juniors to manage all outstanding claims and design an efficient duty program and coordinate with HR team to facilitate same.
• Monitor effectiveness of all programs and provide support to all open claim file reviews and manage all payment cycles to ensure compliance with all contract requirements.
• Analyze all claims to ensure optimal quality and prepare reports for various business units and monitor all chargeback expenses and provide reports to all clients and management.
• Provide all claim kits and auto ID card to various business units and recommend improvements in processes to increase proficiency and supervise effective resolution of all claim inquiries.
• Reviewing, approving, settling or denying complex claims in accordance with claims procedures.
• Oversee all electronic claims processes and evaluate all self-insurance applications and prepare claims reports and evaluate all actuarial.
• Analyze all claims and identify all risks and ensure processing of all claims as per company policy.
• Forecast all staffing requirements and identify and resolve all issues effectively and schedule all employee attendance.
• Ensure underwriting contracts are administered and recorded accurately, and on time.
• Assess risks that are received and underwrite using judgement and experience and in compliance with underwriting guidelines.
• Managing projects, developing and implementing new procedures for underwriting and claims processing to drive forward continuous process improvement.


Required Skills & Competencies
• Demonstrate the ability to communicate and interact with both colleagues and third parties.
• Be positive, self-motivated and possess strong leadership skills.
• Excellent Interpersonal and Customer Service Skills
• Negotiation, Questioning and Decision-Making Skills
• Good Planning and Analytical Skills
• Good Problem-solving skills
• Possess good interpersonal, oral and written communication skills, including the ability to influence and persuade effectively.
• Possess excellent time management skills, be able to multi-task and have the ability to meet deadlines.
• Be a team player.
• Ability to work in high-pressurised environments.

Primary Areas of Accountability:

Qualifications and Experience
• Degree in Pensions and Insurance, Finance or Business related field
• At least a minimum of 7-8 years of experience in Insurance Claims Management
• Must have vast experience in Risk and Compliance Management
• Proven experience in Fraud Management (Prevention & detection)
• In-depth understanding of legal regulations
• Must have a very good Customer service background
• Formal legal training or certification will be a plus
• Must be a member of relevant professional Body


Work Hours: 8

Experience in Months: 84

Level of Education: Bachelor Degree

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Job application procedure

If you meet the minimum hiring requirements for the above position, please email your CV and Cover letter clearly stating your salary expectations to: jobs@bemconsult.com  and copy in bemconsult@outlook.com 




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