About Organisation:

Clarkson Insurance Brokers Ltd strives to provide insurance advisory services that guarantee peace of mind and comfort to our customers in the changing environment through mutual partnerships, technological efficiency, product innovation and continuous customer engagement for the benefit of all in Africa and beyond.

Job Summary: The Claims Officer manages a caseload of claims, ensuring timely and accurate resolution by following established procedures and communicating effectively with clients and stakeholders. They contribute to the development and improvement of claims processes and systems.

Key Duties and Responsibilities:

• KRA 1: Contributes to Claims System Development & Improvement
• Support the Manager, Claims in developing systems, policies, procedures and business processes that will ensure a highly competitive claims performance for CIB’s portfolio:
• Support the Claims Manager to review current claims procedures and identify areas for improvement to enhance efficiency and competitiveness; proactively identify bottlenecks in the current claims workflow and support efforts to streamline processes for faster and more accurate claims handling.
• Assist in drafting and maintaining clear documentation of claims processes and policies, ensuring that they are easily accessible to the team and adhere to industry standards.
• Track key performance metrics related to claims handling (e.g., time to process claims, customer satisfaction) and report findings to the Claims Manager. Support improvements based on data analysis.
• Conduct research into industry best practices for claims management and provide recommendations to the Claims Manager for possible implementation within CIB.
• Organise and participate in regular process review meetings with the claims team and other stakeholders to assess how well new systems and procedures are performing and where adjustments may be needed; document and track any changes or improvements suggested to claims systems, processes, or policies and ensure that all updates are properly communicated and implemented.
• Support the Claims Manager in defining key claims-related metrics, such as claims processing time, customer satisfaction, claims accuracy, and claims settlement rates.
• Prepare regular reports on the claims department’s performance against key metrics. Share these reports with the Claims Manager and other relevant departments for review.
• KRA 2: Supports Client Claims
• Ensure that claims are processed fairly and promptly, maintaining good communication with policyholders throughout the claims process:
• Ensure that claims are acknowledged as soon as they are received and provide policyholders with an estimated timeline for resolution; Ensure that policyholders understand the claims process by providing clear, simple explanations, instructions and documentation.
• Conduct and participate in the inspection of property before submitting or registering a claim.
• Proactively communicate with policyholders throughout the claims process keeping them informed of any updates or changes in the status of their claim.
• Track and monitor the time taken to process each claim, and ensure that claims are handled promptly within established service level agreements (SLAs). Report any delays to the Claims Manager.
• Review each claim fairly and objectively following established policies and procedures and flag any discrepancies or issues to the Claims Manager for further review.
• Ensure that all necessary claim documentation is provided to policyholders quickly; Act as a point of contact for policyholders to help resolve any disputes or concerns that arise during the claims process. Escalate any unresolved issues to the Claims Manager when necessary.
• Keep claim files well-organized and up to date and ensure that all relevant information is documented accurately for easy access by the team and for communication with policyholders.
• KRA 3: Manages External Relationships
• Build and maintain positive relationships with external stakeholders, especially Insurance Providers, Loss Adjusters, and Clients; skillfully mediate any conflicts or disputes:
• Ensure that all client interactions are documented accurately in the CRM allowing for better follow-up and ensuring no client issues are unattended to.
• Ensure that all inquiries from insurance providers, loss adjusters, and clients are responded to quickly, providing accurate information and resolving issues efficiently.
• Engage actively with external stakeholders, carefully assessing their concerns, and escalate any substantial issues to the Claims Manager for further action.
• Effectively manage the expectations of external stakeholders by providing realistic timelines and ensuring transparent communication regarding the necessary actions and information required from them to progress the claim efficiently.
• Participate in meetings and sensitivities with external stakeholders as necessary, ensure comprehensive note-taking and the effective communication of action points or next steps to all parties involved fostering clear understanding.
• In cases of disputes, assist with gathering necessary documents and facts to support fair negotiations with insurance providers, loss adjusters and other stakeholders; ensure that any outstanding issues or concerns are addressed promptly and thoroughly.
• KRA 4: Payments & Client Claims Reporting
• Work collaboratively with Insurance Providers and with colleagues to ensure that timely payments are made to CIB’s clients and to provide claims reports in line with SLAs:
• Monitor and track the claims payment deadlines to ensure they are being met in line with client SLAs. Flag any potential delays to the Claims Manager promptly.
• Regularly update the claims team and clients on the status of claim payments, ensuring clear communication regarding any expected delays or issues.
• Track the time taken from claim approval to payment processing. Report on any delays and assist the Claims Manager in identifying root causes of payment delays.
• Ensure that claims reports are accurate, reflecting the correct status of claims and any other relevant details. Double-check all data before submitting reports to clients.
• In case of delays in claims payment or reporting, assist in identifying the cause and work with the Claims Manager to rectify the issue and prevent re-occurrence; additionally, provide feedback to the Claims Manager on areas where the claims process can be improved to ensure quicker payment processing and more efficient reporting.
• Monitor that both payment and reporting processes adhere to the agreed SLAs. Track any deviations and work with relevant teams to implement corrective actions.
• Maintain an organized system for tracking claims payment statuses, including due dates, payment confirmations, and any issues. Ensure the system is kept up to date for team visibility.
• KRA 5: Supports Data Entry and Reporting
• Ensure that all claims data is entered accurately and in a timely manner into the system, contributing to the preparation of accurate reports that support effective claims management:
• Regularly update the system with new information as it comes in, such as additional client communications or progress updates on the claim.
• Enter and update the claims data into the system ensuring that the information is accurate and up-to-date at all times; review each claim form to ensure that all required fields are completed to avoid errors or missing information.
• Keep track of the deadlines for entering data into the system and prioritize claims based on urgency to ensure timely submission.
• Make sure that all data entered is consistent with company formats to avoid discrepancies or confusion during report preparation; in the case of missing or incomplete data, immediately notify the relevant team member or client to obtain the necessary information
• Conduct regular data integrity checks to ensure the accuracy and completeness of all information entered into the system.
• Support in organising claims data based on claim status (e.g., pending, approved, closed) to make it easier for the team to access and manage.
• Back up data as required by company policies to ensure that all claims information is securely stored for future reference; reconcile any discrepancies in the data by comparing system records with other documents or reports to ensure all information is aligned.
• KRA 6: Supports Management of Risk & Compliance
• Take responsibility for managing the risks associated with the portfolio of claims being managed; ensure compliance with CIB’s Risk Management Framework at all times:
• Stay updated on industry regulations and support the Claims Manager in creating or updating guidelines for managing claims risks and ensuring that claims are processed in line with the company’s risk management strategies.
• Assist in ensuring that all claims policies and procedures comply with current regulatory standards. Track any changes in regulations and help update internal processes accordingly.
• Ensure that all claims are processed in line with internal procedures, regulatory requirements, and company policies to maintain consistency and fairness in handling claims.
• Ensure that all client claims information is stored securely, with restricted access, in line with internal data security policies to prevent unauthorized access or data breaches.
• Maintain and organize client files as per the company’s SOPs ensuring that all necessary documentation is included, easy to locate, and kept up to date for audit purposes.
• Ensure that every claim has accurate, complete, and up-to-date documentation, including claim forms, communication logs, and other supporting materials to ensure compliance and mitigate the risk of incomplete records.
• Support periodic internal audits by ensuring all claims files are complete, properly documented, and stored in line with company policies and regulatory requirements.
• Track and follow up on any risk mitigation actions that have been identified and ensure that corrective measures are implemented and completed on time.

Qualifications, Skills and Experience:

• Bachelor’s degree in Business Administration, Insurance, or a related field.
• Relevant industry certifications or designations (e.g., Associate in Claims) are desirable
• Related Job Experience/Qualifications:
• Minimum 3+ years of experience in a claims handling role, demonstrating a solid understanding of claims processes and procedures.
• Proven ability to effectively manage a caseload of claims, ensuring timely and accurate resolution.
• Experience in collaborating with external stakeholders, such as insurance providers, loss adjusters, and clients.
• Additional skills:
• Strong understanding of insurance principles, claims handling procedures, and regulatory requirements.
• Excellent communication and interpersonal skills, with the ability to effectively communicate with stakeholders at all levels.
• Proficiency in claims management software and systems.
• Problem solving skills, with the ability to identify and resolve complex issues.
• Excellent organizational and time management skills.
• Ability to work independently and manage a busy workload
• Analytical skills; attention to detail

• Support the Manager, Claims in developing systems, policies, procedures and business processes that will ensure a highly competitive claims performance for CIB’s portfolio.
• Support the Claims Manager to review current claims procedures and identify areas for improvement to enhance efficiency and competitiveness; proactively identify bottlenecks in the current claims workflow and support efforts to streamline processes for faster and more accurate claims handling.
• Assist in drafting and maintaining clear documentation of claims processes and policies, ensuring that they are easily accessible to the team and adhere to industry standards.
• Track key performance metrics related to claims handling (e.g., time to process claims, customer satisfaction) and report findings to the Claims Manager. Support improvements based on data analysis.
• Conduct research into industry best practices for claims management and provide recommendations to the Claims Manager for possible implementation within CIB.
• Organise and participate in regular process review meetings with the claims team and other stakeholders to assess how well new systems and procedures are performing and where adjustments may be needed; document and track any changes or improvements suggested to claims systems, processes, or policies and ensure that all updates are properly communicated and implemented.
• Support the Claims Manager in defining key claims-related metrics, such as claims processing time, customer satisfaction, claims accuracy, and claims settlement rates.
• Prepare regular reports on the claims department’s performance against key metrics. Share these reports with the Claims Manager and other relevant departments for review.
• Ensure that claims are processed fairly and promptly, maintaining good communication with policyholders throughout the claims process.
• Ensure that claims are acknowledged as soon as they are received and provide policyholders with an estimated timeline for resolution; Ensure that policyholders understand the claims process by providing clear, simple explanations, instructions and documentation.
• Conduct and participate in the inspection of property before submitting or registering a claim.
• Proactively communicate with policyholders throughout the claims process keeping them informed of any updates or changes in the status of their claim.
• Track and monitor the time taken to process each claim, and ensure that claims are handled promptly within established service level agreements (SLAs). Report any delays to the Claims Manager.
• Review each claim fairly and objectively following established policies and procedures and flag any discrepancies or issues to the Claims Manager for further review.
• Ensure that all necessary claim documentation is provided to policyholders quickly; Act as a point of contact for policyholders to help resolve any disputes or concerns that arise during the claims process. Escalate any unresolved issues to the Claims Manager when necessary.
• Keep claim files well-organized and up to date and ensure that all relevant information is documented accurately for easy access by the team and for communication with policyholders.
• Build and maintain positive relationships with external stakeholders, especially Insurance Providers, Loss Adjusters, and Clients; skillfully mediate any conflicts or disputes.
• Ensure that all client interactions are documented accurately in the CRM allowing for better follow-up and ensuring no client issues are unattended to.
• Ensure that all inquiries from insurance providers, loss adjusters, and clients are responded to quickly, providing accurate information and resolving issues efficiently.
• Engage actively with external stakeholders, carefully assessing their concerns, and escalate any substantial issues to the Claims Manager for further action.
• Effectively manage the expectations of external stakeholders by providing realistic timelines and ensuring transparent communication regarding the necessary actions and information required from them to progress the claim efficiently.
• Participate in meetings and sensitivities with external stakeholders as necessary, ensure comprehensive note-taking and the effective communication of action points or next steps to all parties involved fostering clear understanding.
• In cases of disputes, assist with gathering necessary documents and facts to support fair negotiations with insurance providers, loss adjusters and other stakeholders; ensure that any outstanding issues or concerns are addressed promptly and thoroughly.
• Work collaboratively with Insurance Providers and with colleagues to ensure that timely payments are made to CIB’s clients and to provide claims reports in line with SLAs.
• Monitor and track the claims payment deadlines to ensure they are being met in line with client SLAs. Flag any potential delays to the Claims Manager promptly.
• Regularly update the claims team and clients on the status of claim payments, ensuring clear communication regarding any expected delays or issues.
• Track the time taken from claim approval to payment processing. Report on any delays and assist the Claims Manager in identifying root causes of payment delays.
• Ensure that claims reports are accurate, reflecting the correct status of claims and any other relevant details. Double-check all data before submitting reports to clients.
• In case of delays in claims payment or reporting, assist in identifying the cause and work with the Claims Manager to rectify the issue and prevent re-occurrence; additionally, provide feedback to the Claims Manager on areas where the claims process can be improved to ensure quicker payment processing and more efficient reporting.
• Monitor that both payment and reporting processes adhere to the agreed SLAs. Track any deviations and work with relevant teams to implement corrective actions.
• Maintain an organized system for tracking claims payment statuses, including due dates, payment confirmations, and any issues. Ensure the system is kept up to date for team visibility.
• Ensure that all claims data is entered accurately and in a timely manner into the system, contributing to the preparation of accurate reports that support effective claims management.
• Regularly update the system with new information as it comes in, such as additional client communications or progress updates on the claim.
• Enter and update the claims data into the system ensuring that the information is accurate and up-to-date at all times; review each claim form to ensure that all required fields are completed to avoid errors or missing information.
• Keep track of the deadlines for entering data into the system and prioritize claims based on urgency to ensure timely submission.
• Make sure that all data entered is consistent with company formats to avoid discrepancies or confusion during report preparation; in the case of missing or incomplete data, immediately notify the relevant team member or