Claims Executive at Ark Insurance Group

JOB DESCRIPTION

RESPONSIBILITIES AND DUTIES:

Functional Areas and Responsibilities

• Acknowledge claims notification.
• Confirm if policy is in force and claim validity.
• Registering claims from clients.
•  Notify underwriters of the incident on behalf of client via Arkonline and/or email.
• Gathering and reviewing claim-substantiating documents from clients.
• Profiling of claims in line with policy terms and conditions.
• Reviewing outstanding claims and following up with clients.
• Review of settlement offer to ensure the correct outcomes for clients.
• Communicate settlement offers and breakdown of adjustment to the client after necessary approval from Team lead. 
• Follow up with the client to ensure timely execution of the discharge voucher with necessary account details.
• Ensure receipt of evidence of payment from insurer(s) within a reasonable time frame.
• Forward evidence of payment to client.
• Must ensure that all claims processing activities comply with regulatory requirements and internal policies.
• Responsible for generating reports on claims settlements, processing times, and other key metrics.
• Necessary update MUST be done on Arkonline.
• Any other tasks as may be assigned by the Head of department.

KEY PERFORMANCE INDICATORS

• Acknowledgment of claim notification: Within 24 hours.
• Claim notification to insurer(s): Within 24 hours
• Forward claim documents to insurer(s): Within 24 hours upon receipt from the insured except there are issues with the documents and this must be discussed with the line manager. 
• Communicate offer to the insured: Within 24 hours of receipt of the offer from the insurer. If unsatisfactory, reject offer within 12 hours upon receipt of the offer from the insurer.
• Ensure 100% attendance of nominated trainings.
• Zero tolerance for fraudulent transactions.
• 100% adherence to all SLA

REQUIRED SKILLS AND COMPETENCIES

• Proficiency in the use of Office365 apps such as Word, PowerPoint, and Excel. 
• Ability to take initiatives and work with minimal supervision.
• Teamwork and Interpersonal skills. 
• Negotiation skills.
• Investigative skills.
• Problem-solving skills: Ability to identify and resolve problems.
• Excellent communication skills (Verbal and Written). 
• Technical proficiency.

QUALIFICATIONS

• B.sc/HND in Insurance or any related discipline.
•  Minimum of 5 years’ relevant experience from an insurance or brokerage firm.
•  Professional degree or qualifications are an added advantage (M.sc, MBA, ACIIN).