Detail:Key Performance Areas:
Validation of claims in line with Company guidelines and Standard Operating Procedures Management of Large loss and complex claims Appointment of necessary providers Authorizations\Settlement of claims Rejection of claims Processing payments within the turn-around time Payment confirmations to Brokers and Suppliers Assisting clients and brokers over the phone / email with claims and queries Relationship Management with allocated brokers, including training of brokers with binder and outsource
agreements Oversight and management of binder and outsource brokers Complaints handling and resolution Liaising with Service Providers Liaising with brokers and clients Requirements:
Matric Certificate – essential Regulatory Exam Further Education and Training Certificate in Short-Term Insurance – NQF 4, and/ or a Higher Certificate in
Short term Insurance - NQF 5 Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised. Marine and Engineering knowledge – Highly advantageous Computer literate – Microsoft Word, Excel, and Outlook Experience in Commercial and Personal lines At least 5-10 years’ relevant work experience in claims validations and settlement (both in Motor and NonMotor claims, as well as in both Personal Lines and Commercial Lines classes of business) Work experience within a licensed insurer, or Underwriting Manager. Experienced in making claims settlement determinations with mandate exceeding R250 000.00 Sound technical knowledge and understanding of relevant short term insurance policy wording
