PROCAPITA Management Consulting Hiring for Manager – Claims Management (Non-Motor) at Al Kuwait Full Time

We are looking for suitable candidates for the position Manager – Claims Management. The selected candidate will be responsible for directing all claims activities at the organization which includes processing of Life & Medical and General (Marine, Aviation, Fire, General Accident, etc..) claims.

Roles & Responsibilities:

• Set the claims policies and procedures for Life & Medical and General insurance services.
• Ensure the implementation of Claims Policies & procedures at each of claims centers and are in compliance with the overall Operations guidelines.
• Manage all claims processing activities to ensure quick and efficient completion of claims processing.
• Monitor all claims activities (including investigating and checking the accuracy of claims, evaluation of damage, determination of liability, etc.) and ensure all customer claims are assessed fairly.
• Coordinate with the finance department for claims settlement for insured members and providers.
• Manage and Direct Life & Medical claims in coordination with TPA legislations to ensure that customers are assessed fairly.
• Review and audit suspicious customer claims.
• Manage surveys and estimate losses in coordination with surveyor, when needed.
• Prepare reports for loss ratio from claims in coordination with the underwriting management & make recommendations on means to avoid future losses.
• Review weekly suspended & denied claims report and paid & outstanding claims report.
• Ensure good relations with related service providers handle problems between them and clients and negotiate terms and conditions with the provider.
• Maintain a sound management development plan ensuring sufficient back up.
• Monitor performance and training needs of subordinates in order to maximize their performance to achieve functional objectives.