Job title : Claims Examiner – A&H
Job Location : Gauteng, Johannesburg
Deadline : November 28, 2024
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PRINCIPLE DUTIES AND RESPONSIBILITIES:
Claims Administration
- Register the Claim according to procedure
- Set appropriate reserves in line with policy
- Determine if the loss is covered in terms of the policy
- Assess the Claim based on accurate interpretation of policy wording in place: refer Claims outside Claims mandate
- Appoint / recommend appointment of loss adjusters and/or relevant experts: provide appropriate settlement instructions
- Follow Claims settlement process to ensure timely settlement of Claims and fees
- Conduct timely, professional follow-up correspondence with Clients and Brokers, including Claims rejection
- Provide reports to Claims Manager in line with Claims policies
Customer Service
- Establish and maintain excellent levels of customer service, with particular attention to:
- Responsiveness – speed of service delivery
- Quality of service rendered
- Adherence to internal and external SLA’s
Expense control
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Manage all expenses within budget. Continuously work to reduce the expense ratio through constant attention to efficiencies and opportunities to maximize productivity through streamlining of processes
Audit and Compliance
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Ensure adherence with and implementation of all claims compliance controls as may be specified from time to time by the Claims Manager.
What we’re looking for:
Qualification
- Matric
- Short Term Insurance qualification preferred
- FAIS compliant
Experience
- Minimum of 3 year’s experience as Claims Examiner, including experience in specific Line of Business, as appropriate.
How to Apply for this Offer
Interested and Qualified candidates should Click here to Apply Now
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