CLAIMS ADMINISTRATOR (X1) – Afritec Life Insurance 2501 views

Key Responsibilities

• Assess and adjudicate claims in line with policy terms, underwriting guidelines, and regulatory requirements.
• Validate claim documentation for completeness and authenticity.
• Calculate and process claim benefits accurately and within SLA timelines.
• Capture and maintain accurate claims data on administration systems.
• Identify inconsistencies, potential fraud indicators, and escalate as required.
• Submit approved claims for payment and ensure correct allocation.
• Reconcile claims payments with finance records and investigate discrepancies.
• Communicate claim outcomes clearly and professionally to clients and stakeholders.
• Provide regular updates on claim progress and handle sensitive interactions with empathy.
• Compile claims reports (e.g., turnaround times, claims ratios, repudiations).
• Identify suspicious claims and support fraud investigations.

Requirements

• Diploma in Insurance, Business, or related field.
• COP Long Term Insurance will be an added advantage.
• 1-2 years’ experience in claims administration or insurance operations.
• Strong understanding of policy interpretation and claims processes.
• High attention to detail and accuracy.
• Strong communication and interpersonal skills.
• Integrity, sound judgement, and professionalism.
• Ability to work under pressure and meet deadlines.

How to Apply