Claims Manager

2 weeks ago

Cape Town, Western Cape, South Africa PSG Konsult Full time

Job Description:


As a Short-term Insurance Claims Manager, your primary responsibility will be to oversee and manage the claims process for various types of short-term insurance policies.

You will be responsible for ensuring efficient and accurate claims handling while maintaining a high level of customer satisfaction.

This role requires excellent organizational and analytical skills, as well as the ability to effectively manage a team of claims adjusters.


Responsibilities:

  • Claims Management: Oversee the entire claims process, from initial notification to final settlement, ensuring that all claims are handled in accordance with company policies and industry regulations.
  • Team Management: Lead and manage a team of claims adjusters, providing guidance, training, and performance feedback to ensure the team's productivity and quality standards are met.
  • Claims Evaluation: Review and assess claim submissions, including supporting documentation, to determine coverage eligibility and validate the extent of loss or damage.
  • Investigation: Conduct investigations when necessary to gather additional information or evidence related to claims, such as accident reports, medical records, or witness statements.
  • Documentation and Reporting: Ensure accurate and complete documentation of all claimsrelated activities, maintaining proper records and producing regular reports for management review.
  • Customer Service: Handle complex or escalated customer inquiries or complaints related to claims, providing timely and professional assistance to address concerns and resolve issues.
  • Fraud Detection: Collaborate with the fraud investigation team to identify and mitigate potential fraudulent claims, implementing appropriate preventive measures and reporting suspicious activities.
  • Vendor Management: Liaise with external service providers, such as loss adjusters, lawyers, and medical professionals, to ensure prompt and efficient processing of claims.
  • Compliance: Stay up to date with industry regulations and legal requirements related to insurance claims, ensuring adherence to all relevant guidelines and standards.
  • Process Improvement: Continuously evaluate and identify opportunities to enhance the claims process, suggesting and implementing improvements to increase efficiency and customer satisfaction.

Qualifications:

  • Bachelor's degree in Insurance, Business Administration, or a related field (or equivalent work experience).
  • Extensive experience in shortterm insurance claims management, with a proven track record of successfully handling complex claims.
  • Strong knowledge of insurance policies, coverage, and claims procedures.
  • Excellent leadership and team management skills, with the ability to motivate and develop a highperforming team.
  • Exceptional analytical and problemsolving abilities, with attention to detail and accuracy.
  • Effective communication and interpersonal skills, with the ability to interact professionally with customers, colleagues, and external stakeholders.
  • Proficiency in using claims management software and other relevant tools.
  • Familiarity with fraud detection and prevention strategies in insurance claims.
  • Sound knowledge of insurance industry regulations and compliance requirements.
  • Ability to work under pressure, manage multiple priorities, and meet deadlines.

Ability to commute/relocate:

  • Cape Town,

Western Cape:
Reliably commute or planning to relocate before starting work (required)

Application Question(s):

  • Do you have Short Term Insurance Experience?
  • Do you have commercial line insurance experience?

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