Senior Reinsurance Claims Officer
Level: ARPC 6
The purpose of this role is to apply experienced capabilities in administering efficient Reinsurance claims services in accordance with ARPC’s Claims Policies and Procedures and supporting the Insurer Customer claims audit program of work.
- Understand ARPC’s claims policies and processes.
- Provide of an efficient and effective claims service in accordance with ARPS’s established policies and procedures. Receive, validate, record and process incoming reinsurance claims in accordance with pre-established service level guidelines.
- Maintain data integrity within ARPC’s claims management system.
- Raise questions escalate issues with the EMCAA where ambiguities or unusual situations arise.
- Ensure that all claim’s related matters are dealt within the timeframes set out by ARPC’s service level agreement.
- Identify suspicious or potentially fraudulent claims and notify the EMCAA.
- Arrange investigation and liaise with legal counsel if further action needs to be taken.
- Ensure the claims system is kept up to date with all claims activity, in accordance with established processes and procedures.
- Provide reports as required regarding claims activity.
- Assist in the understanding of claims process issues and risks, recommend, and implement changes based on identified inefficiencies.
Role activities specific to Senior Claims Officer
- Assist in the implementation of the Insurer Customer audit and Review function.
- Undertake Insurer Customer claims audits and to determine the extent of coverage the application of any conditions or exclusions, data integrity and reasonableness of claims reimbursement requests under guidance of the Manager Claims Audit and Investigation
- Reviewing ARPC claims processes and procedures for improvements and identification of areas of risk or non-compliance.
Contact: [email protected]