negotiator: specialist claims

2 weeks ago

Johannesburg, Gauteng, South Africa Old Mutual Full time

Description

To provide excellent Specialist claims services, ensure containment of claims spend, and establish a culture of best practices within our responsibilities.

Critical objectives and responsibilities

  • Strategic thinking
  • Customer centracity
  • Collaboration
  • Leading with Influence
  • Innovation
  • Personal Mastery
  • Executing
  • End-to-end claim processing including negotiation and settlement of Speciality Lines of Business claims
  • Process Speciality lines claims in adherence with SLA.
  • Arrange assessment in adherence with SLA.
  • Review merit of claim.
  • Complete Risk assessment and additional support request analysis.
  • Clarify and amend information where required
  • Appoint the support service required.
  • Review Support Function Report.
  • Calculate and Analyse technical computations.
  • Capture all relevant claims updates and decisions on the system.
  • Manage Diarised actions aligned to SOP
  • Prepare, where required.
  • Prepare Payment with communication details.
  • Await additional information on multiple payments, if required.
  • Continuously improve claims service, manage claims spend, and contain the increase in the average cost of claims.
  • Improve/maintain Speciality Lines Claims service effectively.
  • Reduce/maintain turnaround time of Speciality Lines Claims.
  • Ensure effective implementation and compliance of claims/operational systems or procedures.
  • Ensure diary is maintained.
  • Ensure estimates are raised accurately and timeously in accordance with best practice as and when new claims and new documents are actioned.
  • Adhere to Specialty Claims Standard Operations Procedures
  • Maintain Turn-Around Times
  • Experience, knowledge & skills required
  • Matric
  • Appropriate insurance qualification background
  • Knowledge and interpretation of Specialty Lines policies
  • 3 years Specialty Lines claims handling
  • 5 years Commercial Non-motor experience specifically Corporate Property, Engineering, and Marine
  • Competency Descriptors
  • Strategic: Can understand, identify, and act on broader opportunities to drive longer-term, value-adding changes. Applies judgment effectively. Identifies and acts on market and/or competitor trends/opportunities
  • Customer: Putting the customer at the heart of business decisions and driving to improve value for customers.
  • Collaboration: Creates trust, respect, and builds meaningful relationships. Able to handle a wide range of relational challenges to ensure collaboration across boundaries.
  • Leading with Influence: Influences and rallies people behind common goals; actively supports growth and inspires others to exceed expectations. Communicates clear strategies and objectives for own function.
  • Innovation: Generates creative/out of the box solutions. Challenges the status quo and/or demonstrates the ability to relate to challenges from a range of diverse but relevant perspectives. Willing to take calculated risks when introducing novel ideas.
  • Personal Mastery: Learns and actively works to build self-awareness; develop through experience and feedback from others. Copes effectively with stress and has the resilience to take on stretching and challenging assignments. Adjusts effectively to work within new work structures, processes, requirements, and cultures.
  • Executing: Displays consistent energy, drive, and perseverance in order to deliver results. Demonstrates a willingness to take calculated risks to achieve stretch performance goals.

Skills

Education

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