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

• Keep detailed and accurate records of health business policies underwritten and decisions made (electronically and in physical files)
• Assist in underwriting health insurance risks
• Carry out scheme performance analysis and propose appropriate renewal terms
• Participate in preparation of quotations within set standards
• Prepare policy documents, endorsements debit and credit notes
• Dispatch policy documents, new business and renewal debits and endorsements within set time frames
• Assist in renewal of policies in the system within set time frame
• Attend to correspondence and client queries (both written and by phone) within set timelines
• Capture policy terms and conditions for reference
• Preparation and issuance of medical cards and member certificates within set time frames
• Attend to correspondence and client queries within set timelines
• Prepare reports as may be required from time to time
• Debt management at business entry point and renewal in line with the credit policy
• Implementation of policy suspension and policy cancellations
• Liaison with the other departmental and company functions to ensure smooth delivery of services to insured clients
• Implementation of TCF 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 consistency
• Embrace governance requirements with respect to KYC/AML/Data protection requirements per governing Acts

Qualifications

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

Competencies

• Understanding of insurance operations and concepts
• Knowledge of insurance regulatory requirements
• Excellent organizational and stakeholder management skills

• Keep detailed and accurate records of health business policies underwritten and decisions made (electronically and in physical files)
• Assist in underwriting health insurance risks
• Carry out scheme performance analysis and propose appropriate renewal terms
• Participate in preparation of quotations within set standards
• Prepare policy documents, endorsements debit and credit notes
• Dispatch policy documents, new business and renewal debits and endorsements within set time frames
• Assist in renewal of policies in the system within set time frame
• Attend to correspondence and client queries (both written and by phone) within set timelines
• Capture policy terms and conditions for reference
• Preparation and issuance of medical cards and member certificates within set time frames
• Attend to correspondence and client queries within set timelines
• Prepare reports as may be required from time to time
• Debt management at business entry point and renewal in line with the credit policy
• Implementation of policy suspension and policy cancellations
• Liaison with the other departmental and company functions to ensure smooth delivery of services to insured clients
• Implementation of TCF 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 consistency
• Embrace governance requirements with respect to KYC/AML/Data protection requirements per governing Acts

• Understanding of insurance operations and concepts
• Knowledge of insurance regulatory requirements
• Excellent organizational and stakeholder management skills

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