Claims and Benefits Officer at Old Mutual Kenya in Nairobi, Kenya

    Old Mutual Kenya logo

    Claims and Benefits Officer

    Old Mutual KenyaNairobi, Kenya

    Posted

    5 days ago

    Apply by

    25 Aug

    Full Time
    On Site
    Mid
    Banking, Insurance & Financial Services
    Banking, Insurance & Financial Services

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    Job Description

    The Claims and Benefits Officer is responsible for end-to-end processing of Group Life and Credit Life claims, ensuring accurate assessment, efficient processing, and exceptional service delivery. The role ensures adherence to policy terms, internal claims guidelines, regulatory standards, and risk mitigation practices, supporting the integrity and sustainability of the corporate claims function.

    Key Responsibilities

    • Register and acknowledge claims within agreed timelines and ensure completeness of claim documentation
    • Perform claims assessment in line with policy terms, underwriting notes, and applicable reinsurance arrangements
    • Prepare claim summaries and recommendations for approval based on internal authority limits
    • Coordinate with internal stakeholders underwriting, reinsurance, legal to support accurate and defensible claims decisions
    • Follow up with clients, brokers, or medical providers to resolve outstanding requirements or clarifications
    • Ensure timely communication of claim outcomes to clients and intermediaries with empathy and professionalism
    • Track and maintain claims registers and contribute to analysis of claims experience and turnaround performance
    • Support escalations and contribute to reviews of declined or disputed claims by compiling supporting evidence
    • Ensure claims handling activities fully comply with internal claims guidelines, Anti-Money Laundering AML regulations, Data Protection Act DPA, and Insurance Regulatory Authority IRA claims handling expectations
    • Conduct beneficiary verification and escalate suspicious claims in line with AML/CFT policy
    • Ensure confidentiality of personal and medical data is maintained at all times

    Required Qualifications

    • Strong knowledge of life insurance claims principles and policy interpretation
    • High attention to detail and accuracy in claims documentation
    • Empathy and emotional intelligence when dealing with bereaved clients
    • Analytical and problem-solving capabilities in adjudicating complex claims
    • Good written communication and reporting skills
    • Team player with ability to coordinate across departments under pressure
    • 2–3 years' experience handling group life or credit life claims
    • Bachelor's degree in Commerce BCOM, or a business-related field
    • Professional insurance qualification e.g., AIIK, ACII, LOMA

    Job Details

    Job Function

    Banking, Insurance & Financial Services

    Minimum Experience

    2 years

    Education Level

    Bachelor’s Degree

    Area of Study

    Business

    Field of Study

    Commerce

    Languages

    English

    Additional Information

    How to Apply: Interested and qualified? Go to Old Mutual Kenya on oldmutual.wd3.myworkdayjobs.com to apply.

    Master the Claims Adjudication Screen

    Claims roles are about balancing empathy with strict policy interpretation. Hiring managers will probe how you handle incomplete documentation, tight timelines, and sensitive conversations with grieving families.

    1. Show your claims process knowledge: On your CV, detail your experience with group life or credit life claims from registration to settlement. Mention specific steps you handled, like beneficiary verification or reinsurance coordination, to prove you know the full lifecycle.

    2. Prepare for policy interpretation questions: Be ready to explain how you would assess a claim against policy terms and underwriting notes. Review common exclusions and riders in life insurance to speak confidently.

    3. Highlight your regulatory awareness: Mention your familiarity with AML, DPA, and IRA requirements. Give an example of how you ensured compliance in a past role, such as escalating a suspicious claim.

    4. Demonstrate empathy in practice: Expect scenario questions about communicating claim denials. Share a real example where you delivered bad news with compassion while maintaining professionalism.

    5. Emphasize your coordination skills: Claims involve multiple stakeholders—underwriting, legal, brokers. Describe a time you collaborated across departments to resolve a complex claim.

    6. Quantify your accuracy and speed: Use numbers to show your efficiency, like 'processed 50 claims per month with 98% accuracy' or 'reduced turnaround time by 20%'.

    7. Brush up on your reporting skills: You'll need to write clear claim summaries and reports. Prepare to discuss how you document decisions and maintain claims registers.

    8. Show your commitment to learning: If you have AIIK, ACII, or LOMA, highlight it. If not, mention your plan to pursue these qualifications to show dedication to the field.

    CareerSasa Safety Alert: Never pay employers or agencies for interviews, training, or job placement. Does a job request payment? Report it immediately using the "Flag" button. While CareerSasa vets job postings thoroughly, always verify opportunities independently.
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    Tags

    claims processing
    group life
    credit life
    insurance
    AML