 |
| AJIRALEO |
Jobs in Tanzania 2019: 2 Job Opportunities at Britam Insurance Tanzania | Deadline: 15th February, 2019
AJIRA TANZANIA 2019 / NAFASI ZA KAZI 2019
Claims Assistant – Medical – (1900000L)
Job Purpose and Key responsibilities
The role holder will be responsible for processing medical claims
with a focus on controlling and management of member benefits through
vetting of inpatient and outpatient bills. The role will report to the
Assistant Manager-Medical Claims
- Verify and capture outpatient and inpatient claims as per the claims manual
- Assess medical claims documents for authenticity and process payments within set service levels
- Register and process all reported medical claims and appoint relevant service providers where applicable and advice the clients on the required claims supporting documents
- Raise payment requisitions within the set standards
- Liaise with the finance department to ensure safe and timely dispatch of reimbursement claims cheques to clients
- Ensure all claims documents are archived in the relevant systems Assist in case management activities
- Promptly and efficiently attend to customer queries, and complaints
- Deliver on performance requirements as defined in the departments’ strategy map, balanced scorecard and Personal Scorecard.• Gross Loss Ratio
• Customer turnaround time
• Accuracy in posting
Internal Relationships:
• Required to liaise and work closely with the other departments as may be necessary
• Britam customers
• Insurance sector players
• Hospitals and other service providers
Knowledge, experience and qualifications required
- Diploma (Nursing and Medicine preferred)
- 1-2 years’ experience in medical claims
- Knowledge of Britam health product
- Learning and Researching: Rapidly learns new tasks and commits information to memory quickly; demonstrates an immediate understanding of newly presented information; gathers comprehensive information to support decision making at management level; learns from successes and failures and seeks colleague and customer feedback.
- Working with People: Shows respect for the views and contributions of other team members; shows empathy; listens, supports and cares for others; consults others and shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
- Applying Expertise and Technology: Applies specialist and technical expertise; uses technology to achieve work objectives; develops job knowledge and expertise (theoretical and practical) through continual professional development; demonstrates an understanding of different organisational departments and functions.
- Delivering Results and Meeting Customer Expectations: Focuses on customer needs and satisfaction; exhibits high standards for quality and quantity; monitors and maintains own quality and productivity; works in a systematic, methodical and orderly way; consistently achieves projects goals.
- Following Instructions and Procedures: Follows procedures and policies; keeps to schedules; arrives punctually for work and meetings; demonstrates commitment to the organisation; complies with legal obligations and safety requirements of the role.
- Adhering to Principles and Values: Upholds ethics and values; demonstrates integrity; accepts diversity; display individual responsibility towards the community and the environment; models the organisational values during every day interactions.
Primary Location : Tanzania, United Republic of-Dar es Salaam-Dar es Salaam
Organization : International Insurance Business
Job Type : Permanent
Shift : Day Job
Contract Type : Full-time
Job Posting : 08-02-2019
Unposting Date : 15-02-2019
Reinsurance Officer – (1900000K)
Job Purpose and Key responsibilities
The role holder will be responsible for looking after the various reinsurance arrangements including treaty and facultative reinsurance protection for all classes of business written by the company. Will also be responsible for implementation of the company’s reinsurance programme based on overall company objectives and maintain a business relationship with the company’s underwriting and finance departments and with the local, regional and international reinsurance market.
The officer shall also ensure compliance with respect to facultative placements outside the Country as well as excellent service to globally referred business.
The role will report to the Underwriting Manager.
- Assist to analyze the risks accepted and ensure risks are ceded properly.
- Assist in ensuring that all acceptances are protected by proper reinsurance arrangement on a back to back basis without any gaps in risks accepted and reinsurance protection availed.
- Obtain all necessary underwriting information required to place the risk in the local reinsurance market.
- Assist in arranging proper reinsurance protection as and when required.
- Place reinsurance directly to the market or through the broker whether on facultative or any other basis depending on the need of the situation.
- Assist in the administration of the reinsurance program.
- Ensure timely submission of closing and accounting documents as well as for settlement of premium recovery of claims from reinsurers.
- Ensure accuracy of reinsurance contract with reference to original terms at which reinsurance is accepted.
- Maintain efficient communication lines between the company, brokers, reinsurers and other business partners.
- Prepare reinsurance underwriting and claims statistics on a regular basis and update the same at periodic intervals as per requirement.
- Review reinsurance payments/recoveries relating reinsurance premium, commissioning and claims.
- Ensure prompt claims recovery
- Ensure compliance with various regulations/circulars regarding externalization of risks
- Ensure excellent services with regard to globally referred business
- Ensure attainment of facultative reinsurance budgets through reciprocal business relationship with targeted insurers
- Obtaining insurance quotations for complex risks in liaison with Reinsurance Brokers and Reinsurers
- Seeking special approval for special risks in line with reinsurance treaty requirements
- Deliver on performance requirements as defined in the departments’ strategy map, balanced scorecard and Personal Scorecard.
• Proper ceding of risks
• Facultative inward business
• Customer turnaround time
• Timely notification of excess of loss claims
• Accuracy in posting and documentation
• Reconciliation of booked business
• Regulation Compliance on externalized risks
• Turn Around Times for Globally referred business
Internal Relationships:
• Responsible to Underwriting Manager
• Required to liaise and work closely with finance and claims department
External Relationships:
• Reinsurance companies
• Reinsurance brokers
• TIRA
• Insurance companies
• Brokers
Knowledge, experience and qualifications required
- A business related University Degree – insurance, statistics, actuarial science, accounts preferred
- Professional Insurance qualification (Diploma CII) or equivalent
- Must have a minimum of 3 years’ experience in reinsurance field.
- Knowledge of reinsurance treaty, facultative wording and reinsurance slips preparation a must.
- Presenting and Communicating Information: Speaks fluently; expresses opinions, information and key points of an argument clearly; presents effectively; responds quickly to others ‘reactions and feedback during conversations; projects credibility.
- Working with People: Shows respect for the views and contributions of other team members; shows empathy; listens, supports and cares for others; consults others and shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
- Adhering to Principles and Values: Upholds ethics and values; demonstrates integrity; encourages individual responsibility towards the community and the environment; models the organisational values during every day interactions.
- Analysing: Analyses numerical data and all other sources of information, to break them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgements from the available information and analysis; demonstrates an understanding of how one issue may be part of a much larger system.
- Planning and Organising: Adhere to and monitor clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organises resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
- Delivering Results and Meeting Customer Expectations: Focuses on customer needs and satisfaction; sets and models high standards for quality and quantity. Monitors and maintains quality and productivity. Works in a systematic methodical and orderly way. Consistently achieves projects goals.
Organization : International Insurance Business
Job Type : Permanent
Shift : Day Job
Contract Type : Full-time
Job Posting : 08-02-2019
Unposting Date : 15-02-2019
Number of Openings : 1
No comments:
Post a Comment