Claims Executive at Ark Insurance Group

About the Role

An established insurance company is recruiting a Claims Executive to join their team in Lagos, Nigeria. This position is responsible for managing the complete claims lifecycle, from initial notification through final settlement, ensuring compliance with regulatory requirements and delivering excellent service to clients.

Responsibilities and Duties

• Acknowledge claims notifications from clients
• Verify policy status and claim validity
• Register claims in the system
• Notify underwriters of incidents on behalf of clients via Arkonline and/or email
• Gather and review claim-substantiating documents from clients
• Profile claims in line with policy terms and conditions
• Review outstanding claims and follow up with clients for timely resolution
• Review settlement offers to ensure correct outcomes for clients
• Communicate settlement offers and adjustment breakdowns to clients after approval from Team Lead
• Follow up with clients to ensure timely execution of discharge vouchers with necessary account details
• Ensure receipt of payment evidence from insurers within reasonable timeframes
• Forward payment evidence to clients
• Ensure all claims processing activities comply with regulatory requirements and internal policies
• Generate reports on claims settlements, processing times, and key metrics
• Update all claim information on Arkonline as required
• Complete additional tasks as assigned by the Head of Department

Key Performance Indicators

• Acknowledge claim notifications within 24 hours
• Notify insurers of claims within 24 hours
• Forward claim documents to insurers within 24 hours of receipt from the insured (except where document issues exist, which must be discussed with the line manager)
• Communicate settlement offers to the insured within 24 hours of receipt from the insurer
• Reject unsatisfactory offers within 12 hours of receipt
• Achieve 100% attendance at nominated trainings
• Maintain zero tolerance for fraudulent transactions
• Maintain 100% adherence to all SLAs

Required Skills and Competencies

• Proficiency in claims management systems
• Strong organizational and time management abilities
• Excellent written and verbal communication skills
• Attention to detail and accuracy in documentation
• Customer service orientation
• Knowledge of insurance policies and claims procedures
• Ability to meet tight deadlines and KPIs