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.
• Maintain regular internal (to staff) and external (to customers) communication on Customer Service matters implementing customer experience strategy for the company.
• Perform any other duties as may be assigned from time to time.

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 3-4 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.