Job Description

Key responsibilities/What you do:

• Leading a team of claims adjusters to active the required departmental KPIs in line with orgnisation goals .
• Act as a liaison between the Global Management and the claims team, ensuring clear communication and alignment of objectives.
• Development and implementation of departmental strategies and goals.
• Provide regular updates and reports to the Regional Management on team performance, claims processing, and customer satisfaction.
• Participate in strategic planning with clear decision-making processes.
• Provide guidance, training, and mentorship to team members to enhance their skills and performance.
• Monitor team workload and ensure equitable distribution of tasks.
• Review complex or escalated claims and provide guidance on claim determinations.
• Resolve escalated customer inquiries and complaints regarding claims issues.
• Analyse claims data and performance metrics to identify trends and opportunities for process improvement.
• Prepare and present reports on claims activities, outcomes, and key performance indicators (KPIs) to senior management.
• Utilize data analysis to drive strategic decision-making and optimize claims processes.
• Actively participate in various operational activities, outside of claims, to ensure that operational service delivery is coordinated to meet and exceed clients’ expectations.
• Assist in Developing and updating claims policies and procedures.
• Ensure team adherence to all regulatory and company guidelines.
• Prepare and present regular reports on claims activity, performance metrics, and trends.
• Analyse data to identify areas for improvement and implement corrective actions.
• Other Ad hoc duties as require
  

Key Requirements/What You Bring

• Bachelor’s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
• Minimum of 8 years of experience in claims management or a related field, with at least 4 years in a leading role.
• Proven track record of effectively managing teams and achieving operational goals.
• Strong leadership and team management skills.
• Excellent communication, negotiation, and interpersonal skills.
• Analytical mind-set with the ability to interpret complex data and make data-driven decisions.
• Proficiency in claims management software and Microsoft Office Suite.
• Detail-oriented with strong organizational and time management skills.
• Ability to work in a fast-paced environment and manage multiple priorities effectively.
• Flexibility to adapt to changing business needs and work under pressure.
• Legally permitted to work in the country of operations.