Job Description

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Complex claims Specialist

Details

Closing Date 2023/10/09
Reference Number HOL231002-4
Job Title Complex claims Specialist
Business Unit Hollard Insure
Department Property & Energy
Job Family Operations - incuding Claims, Policy Servicing, Underwriting and Retentions
Job Type Classification Permanent
Reporting To Head : Corporate
Number of Positions 1
Location - Town / City parktown
Location - Province Gauteng
Location - Country South Africa
Job Advert Summary

Helloxe2x80xa6 an exciting new opportunity has just become available in Hollard Insure, Broker Distribution. We are looking to recruit a Complex claims Specialist in Property & Energy, based in Parktown.

Role Objectives:

• Process all complex claims assigned, within the set standards required by the company thus contributing to the effectiveness and efficiency standards of the department.

• Managing complex claims according to the Claims Process, mitigating risk, managing budget, engaging with key stakeholders and tracking timelines against plan.

• Enhance the image of the company through the continuous delivery of efficient and effective customer service.

• Ensure all technical aspects & specialist functions for claims management and fulfilment are adhered to.

Key Responsibilities:

• Technical expertise: To evaluate and investigate all claims received in accordance with policy coverage.

• Stakeholder Management: Maintain a high level of service to all stakeholders identified (internal and external) according to the service standards set.

• Reporting: Provide necessary reporting on financial and operational indicators relating to claims, keep all records and systems up to date. Provide feedback (reporting) to senior management on achievements, pending issues, problems and suggested recommendations.

• Effective and timeous communication: Communicate in a professional manner with internal and external parties and respond to queries within a reasonable time. Keep relevant parties abreast of claims status and development, utilising the claims process as represented in the Standard Operating Procedure.

• Estimate Management: to ensure that estimates loaded are tracked, monitored and managed as required.

• Working with Reinsurance department on recoveries of large losses.

• Risk management: Underwriters to be advised of claims revealing adverse risk features as soon as they are evident.

• Processing: All processes to be adhered to at all times.

• Record Keeping: All relevant claims documentation and communication to be saved on the claims system and loaded timeously.

• Quality control: Quality standards to be adhered to always.

• Relationship management: Working with all relevant parties i.e. both internal and external relationships.

• Continuous Process Improvement: Ensure full compliance to all processes, policies and procedures and identify areas for improvement.

• Variance Management: Adhere to standards set by Hollard. Provide action plans and follow up with corrective actions to all variances.

Required Knowledge and Experience

• At least 7 yearsxe2x80x99 or more in complex / corporate claims handling.

• Corporate claims experience to include:

• Claims procedure

• Insurance terminology

• Legal knowledge (prescription act, insurance act, FAIS)

• Underwriting knowledge (ability to interpret policy wording, understanding how claims information impacts on underwriting)

• Advanced risk assessment knowledge (understand the assessment process, with an ability to appoint the right assessor)

• Reinsurance and treaties (basic understanding)

• Product knowledge

• Basic financial knowledge (estimates, premiums, co-insurance)

• Advanced Excel knowledge

• Claims Trending

• Ability to work under extreme pressure

• Self-management skills (can organise work, space, time)

• Communication skills (express oneself in a clear and concise way)

• Relationship management skills (have the right approach with the right people)

• Accuracy in the analysis, interpretation and basic calculations of data pertaining to claims settlement/estimates.

• Accuracy in the capturing of data to the business system

• Demonstrate common sense, self-motivation and discipline

• Well-presented / representative of Hollardxe2x80x99s image

• Visibly demonstrate the Hollard values

• Visibly assisting Hollard being the best corporate insurer

• Good knowledge of MS Office xe2x80x93 Intermediate level (including Word, Excel, Outlook)

• Career orientated

• Negotiation skills

Educational Requirements

• Matric

• Insurance qualification or equivalent

• Re 5 (Fais Exam)

Policy

We are committed to Employment Equity when recruiting internally and externally. It is company policy to promote from within wherever possible. Therefore, please be aware that internal candidates will be considered first before reviewing external applicants, provided that this supports achievement of our Employment Equity goals. We encourage applicants living with disabilities to apply.

Hollard does not charge individuals seeking employment any fees, whether for registration, application, administration or placement.

xc2xa9 Hollard. All rights reserved.

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