Binder & Outsourced Claims Specialist

2 weeks ago


Johannesburg, Gauteng, South Africa Unique Personnel Full time

Job Number

  • 68924

Job Type

  • Permanent

Job Title

  • Binder & Outsourced Claims Specialist

Computer Skills

  • MS Excel,MS Outlook,MS Word,TIAL

Industry

  • Insurance
  • Brokering

City

  • Johannesburg

Province

  • Gauteng
  • Validation of claims in line with Company guidelines and Standard Operating Procedures
  • Appointment of necessary providers
  • Authorizations\Settlement of claims
  • Rejection of claims
  • Processing payments within the turnaround time
  • Payment confirmations to Brokers and Suppliers
  • Relationship Management with allocated brokers, including training of brokers with outsource agreements
  • Complaints handling and resolution
  • Liaising with Service Providers
  • Liaising with brokers and clients

Core Competencies Required

  • Ability to plan and prioritise own time and work commitments to deliver timeous claims service within agreed turnaround times
  • Ability to take initiative and respond proactively and independently to situations to secure positive results
  • Accepts ownership and accountability for one's own actions and decisions
  • Is open to learning opportunities and is committed to continuous selfdevelopment
  • Ability to communicate openly, and with impact
  • Ability to adapt one's communication style and content to the audience and context.
  • Ability to easily connect with others and develop professional relationships and partnerships with others
  • Strong listening skills
  • Demonstrate high levels of customer centricity and empathy
  • Effective numerical skills and ability to think analytically with good attention to detail
  • Solution based thinking
  • Problem solving ability
  • High levels of selfperception (confidence, selfempowerment, optimism, selfrespect)
  • Ability to function independently, demonstrating good control and composure under pressure
  • Must have high inner values of Honesty, Integrity and reliability
    Inherent 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
  • Class of Business certification (Personal Lines & Commercial Lines)
  • Must be compliant with FAIS Fit and Proper requirements with trackrecord of working unsupervised.

MINIMUM OTHER TRAINING REQUIRED

  • Computer literate
  • Microsoft Word, Excel, and Outlook
  • Experience working on TIAL highly advantageous
  • Experience in Commercial and Personal lines

MINIMUM YEARS OF FORMAL & INFORMAL TRAINING REQUIRED

  • At least 510 years relevant work experience in claims validations and settlement for both Personal Lines and Commercial Lines Non-Motor claims
  • Work experience within a licensed insurer, or Underwriting Manager (UMA).
  • Experienced in making claims settlement determinations with mandate exceeding R250 000
  • Sound technical knowledge and understanding of relevant short term insurance policy wording

What Qualification

  • Short-Term Insurance
  • NQF 4, and/ or a Higher Certificate in Short term Insurance
  • NQF
5

Minimum Qualification

  • Certificate

Status

  • Available


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