Key responsibilities:

• Responsible for managing BMI claims processes (design, data entry, vetting, approvals & payments).
• Responsible for client relations management by ensuring quality service & periodic interactions with clients.
• Designing & implementing innovative initiatives to improve customer satisfaction & retention.
• Setting up client feedback systems to enable process improvements informed by client inputs/feedback.
• Coordinate processing and payment of claims , management of service providers and operational process improvements
• Management of claim processing flows to ensure efficiency and manage case management activities.
• Control and oversee provider recruitment into segment provider panel.
• Advice on processes improvement through automation of tasks and processes.
• Coordinating management of relationships with clients, intermediaries and service providers.
• Providing leadership and mentorship to the claims team.
• Developing suitable operational procedures to meet strategic objectives of the organization.
• Review documents and pertinent requirements regarding claims.
• Ensure claims made by the clients are complete in form and complies with the documentary requirements of an insurance claim.
• Respond to both internal and external client inquiries concerning claims process, service providers, and the filing/completion of proper forms.
• Prepare claims registers for claims meetings and update the various claims reports.
• Delegated Authority: As per the approved Delegated Authority Matrix.
• Perform any other duties as may be assigned from time to time.

Knowledge, experience and qualifications required:

• Bachelor’s’ degree in Nursing.
• Strong AI and Analytical Skills
• Professional qualification in Insurance is a must.
• At least 6 years’ experience in insurance claims management three of which should be in a supervisory position.
• Knowledge of insurance regulatory requirements.
• Knowledge of insurance products.