Job Description

RECOMMENDED QUALIFICATIONS:
Matric, FAIS compliant (within prescribed deadline)
Successfully passed RE 1
Effective time management skills, System A and computer literacy (word, excel, outlook), Email and Telephone Etiquette, SOP Concept
Minimum five years relevant work experience in short term insurance claim settlement (Commercial claims, Motor and Non-Motor). Motor Aggs / Co-insurers / XOL Insurance / Assets based policies.
COMPETENCIES REQUIRED TO PERFORM OUTPUTS AND ROLES ASSOCIATED WITH THESE OUTPUTS:
Results oriented
Commitment
Proficiency
Continuous Learning
Honesty and Integrity
Adaptable to change
Strategic thinking
Team player
Goal oriented
Coaching and consulting
Time management
Communication skills
Ability to build good relationships
Work well under pressure
Claims Handling
Managing own area of control

Registering of new claims:
Register all new claims received (as outlined in the registration SOP) and raise an appropriate reserve as outlined in the reserving methodology.
All claims received must be registered on the claims system within 24 hours.
All claims received after 15:00 must be registered before 12:00 on the following business day
Action any immediate claims processing requirements in accordance with the relevant Claims procedure manual i.e. Appointment of specialist (assessor/adjuster/repairer/supplier)
Diarise all newly registered claims for the next appropriate action date i.e. to follow up on specialist report/ outstanding documentation to ensure claims processing happens timeously
Continuously update the claims activity TAB in respect of all actions taken on the claim
Regular liaison and communication with broker/ client on progress of the claim

Actioning of Queries (telephone and email):

Attend to all queries received relating to "in-progress" claims timeously as per company turn-around times
Action any claims processing requirements on receipt of new claims information, within the prescribed company turn-around times
Amend reserves in accordance with reserving methodology and new information received
Diarise all "in-progress" claims for the next appropriate action date to ensure claims processing happens timeously
Continuously update the claims activity TAB in respect of all actions taken on the claim
Regular liaison and communication with broker/ client on progress of the claim

Action current day diary/ User note:

Attend to all current day diary and user note items timeously as per company turn-around times
Action any claims processing requirements as outlined in the diary or user note item, within the prescribed company turn-around times
Amend reserves in accordance with reserving methodology based on the action of the diary or user note item
Re-diarise(where necessary) all "in-progress" claims for the next appropriate action date to ensure
claims processing happens timeously
Continuously update the claims activity TAB in respect of all actions taken on the claim
Regular liaison and communication with broker/ client on progress of the claim

"In-Progress"/ Outstanding claims:

Action any claims processing requirements in respect of the "In-Progress"/ Outstanding claims as per the target provided by the Team Leader. (daily)
Amend reserves in accordance with reserving methodology based on the action required on the claim
Diarise (where necessary) all "in-progress" claims for the next appropriate action date to ensure claims processing happens timeously
Continuously update the claims activity TAB in respect of all actions taken on the claim
Regular liaison and communication with broker/ client on progress of the claim
Provide daily feedback on actioned claims (as per the target agreed) to the Team Leader

• Ensure invoices and Agreements of loss are processed for payment in accordance with SOP and Management requirements

Finalise/ Settle claims in accordance with relevant company claims procedure

Managing own area of control:

Timely Responses to email and telephonic messages.
Ensure that accurate record is kept of all new matters received in the dept.
Maintaining professional behavior and work ethic at all times
Display personal accountability for own actions, quality of work and personal development
Ensure that all deadlines are met
Exhibit Core Values at all times (Professionalism, Integrity, Perseverance, Positive Attitude)
Keeping to prescribed hours/ timekeeping
Team player and adhere to the backup arrangement as required by department to ensure cohesion

JobPlacements.com