Job Summary

The role holder will be responsible for assisting in risk management through assessing the eligibility of applicants to obtain medical cover, scheme performance analysis, proposal of appropriate renewal terms and scheme administration for those already on medical cover within the set standards of service.

Key Responsibilities

• Maintain detailed and accurate records of health business policies underwritten and decisions made (electronically and in physical files).
•  Underwriting of health insurance risks.
•  Membership management for new and existing business.
•  Preparation and issuance of medical cards and member certificates within set time frames
•  Preparation and issuance of debits, and credit notes within set time frames
•  Preparation and issuance of policy documents.
•  Maintain policy terms and conditions for reference.
•  Implementation of policy suspension and policy cancellations
•  Carry out scheme performance analysis and propose appropriate renewal terms.
•  Renewal of policies in the system within set time frame.
•  Client relationship management. Maintain cordial relationships with clients and brokers through regular engagements and meetings.
•  Attend to correspondence and client queries (both written and by phone) within set timelines.
•  Liaison with the other departmental and company functions to ensure smooth delivery of services to insured clients.
•  Preparation and issuance of various reports as may be required from time to time.
•  Provider liaison to ensure that all providers have updated scheme and membership records.
• Reconciliation of Smart Applications and Orbit medical system records to ensure data accuracy and consistency.

Qualifications

•  Bachelor’s degree in insurance or business-related discipline
•  Progress towards Diploma in Insurance (ACII or AIIK), (at least 3 papers or equivalent)

Experience

•  2 years’ experience in the insurance industry

Competencies

•  Customer, market and competitor understanding.
•  Knowledge of insurance industry and concepts
•  Knowledge of insurance regulatory requirements
•  Knowledge of medical underwriting processes, procedures and concepts
•  Negotiation skills
•  Business management skills
•  Excellent analytical skills
•  Excellent organizational and stakeholder management skills