Claims Analyst

About the role

Old Mutual is seeking a Claims Analyst to join its insurance team. The role involves reviewing, analyzing, and processing insurance claims to ensure they are valid, accurate, and compliant with policy terms. You will work closely with claimants, service providers, and internal departments to resolve claims efficiently.

Key responsibilities

• Review and evaluate insurance claims for accuracy, completeness, and policy compliance.
• Gather supporting documentation and liaise with claimants, service providers, or third parties.
• Determine claim validity and recommend payment, denial, or further investigation.
• Calculate benefit amounts or reimbursements according to policy coverage.
• Communicate with policyholders to clarify information and resolve discrepancies.
• Document decisions and correspondence in the claims management system.
• Monitor claims through resolution, ensuring timely processing and follow‑up.
• Collaborate with underwriting, legal, and customer service as needed.
• Identify trends or irregularities that may indicate fraud and escalate appropriately.
• Ensure compliance with regulatory requirements, industry standards, and internal policies.

Required profile

• Bachelor’s degree in Insurance, Actuarial Science, Business Administration or related field.
• Progress towards an insurance certification (e.g., AIIK, ACII) is preferred.
• Minimum of 3 years experience in insurance claims processing.
• Strong knowledge of general insurance products and the claims lifecycle.
• Familiarity with regulatory requirements and fraud detection techniques.

Required skills

What we offer

• Opportunity to work within a leading African financial services group.
• Professional development and support for certification.
• Collaborative environment with cross‑functional teams.