Job Purpose:
Co-ordinate activities and support services within the Business Processing and compliance operations maintaining prompt, efficient and effective operational support.
Key responsibilities:
- Process all policies new and renewal as per SLA and within the set guidelines.
- Preparation of data upload files- Benefit set up and Member upload files and ensure set up of correct benefits for each corporate schemes and Retail policies.
- Process all claims from service providers, sort out invoices with reconciliations issues shared by finance (stuck invoices within the process, resubmissions).
- Process all reimbursements as per SLA.
- Process all endorsements as per SLA.
- System testing, validation and continuous innovation on processes and training of colleagues as required from time to time.
- Performing Quality assurance on captured claims ensuring reduced reconciliation challenges and that business does not suffer any loss from fraudulent claims.
- Ensure customer data quality and compliance is maintained across all operations as required.
- Schemes reconciliation and maintenance of client data – Data reconciliation for Renewals and New Business policies.
- Master policy creation and conversation for new retail policies.
- Processing of retail policies and advising finance on receipt and allocation of premiums for retail policies booked.
- Preparation and request of medical cards within set TAT and maintaining clear records on requested and issued cards to clients.
- Preparation and presentation of departmental and business reports – Daily and Monthly reports.
- Maintain regular internal (to staff) and external (to customers) communication on Customer Service matters implementing customer experience strategy for the company.
- Delegated Authority: As per the approved Delegated Authority Matrix
Key Performance Measures:
As described in your Personal Score Card.
Knowledge, experience and qualifications required
- Bachelor’s degree in a business-related field.
- At least 4-6 years’ experience in a similar position.
- Progress in Professional qualification in Insurance (ACII, FLMI or IIK).
- Computer Literate; emphasis on Microsoft Office and EDMS.
Technical/ Functional competencies:
- Knowledge of insurance regulatory requirements.
- Knowledge of insurance products.
- Good communication and customer service skills.
- Should possess functional knowledge, be result oriented and have problem solving skills.
- Consistency in adherence to the application of established policies, processes, procedures and tools in achieving compliance requirements, optimal efficiency, and resource utilization.
- Interpersonal skills to effectively communicate with and manage expectations (internal) and other stakeholders who impact performance.
- Self-empowerment to enable development of open communication, teamwork and trust that are needed to support performance and customer-service oriented culture.
- Ability to take initiative/responsibility to ensure that daily duties, routines and related additional tasks are completed timely.
