Life claims administrator

Accountabilities:



– Reviews and approves (as applicable) the submission of all life claims made against company-issued policies and products

– Oversees the work of Claims Examiners to ensure that all procedural requirements are met before claims can be approved for payment within stated limits

– Conduct random validation on Claims approved by Examiners

– Effectively discharge the Company’s People Leader Goal

– Organize and prioritize work in the Claims Department to consistently meet standard TAT’s

– Intervenes and resolves conflicting issues in respect of claims submissions

– Ensures that all supportive paper-work and related requirements are in place to support the payment of claims made against company-issued policies and products

– Prepares and presents supporting weekly & monthly reports, analyses and recommendations on life-claims portfolio performance

– Assists clients/customers as required in minimizing the occurrences of incorrect claims submissions

– Undertakes special projects and assignments as may be determined by the reporting Manager from time to time

– Periodically review processes and resources for optimal performance and making recommendations to management

– Assists with customer queries as required

– Provides ad hoc requested reports as required

– Perform other related duties as assigned



Skills Requirements:

– Excellent communications skills – Verbal & Written

– Strong negotiation and conflict-resolution skills

– Proven supervisory and people leadership skills

– Very good knowledge and use of MS Office Excel and Powerpoint

– Proficiency in reviewing policy contracts terms and conditions in application to Claims adjudication

– Excellent analytical and reporting skills



Experience Requirements:

– Seven (7) years demonstrable experience in an insurance life claims administration (processing/review) environment of which at least 3 years at Supervisory level.



Education, Knowledge and Certification Requirements:

– Associate Degree in a related discipline from an accredited institution.

– LOMA/ ACS/ ALHC

– Above-average knowledge of the credit union movement and its dynamics