negotiator : specialist claims
2 weeks ago
To provide a quality Specialist claims service, ensure containment of claims spend and provide excellent service in setting a culture of best practice within mandated responsibility.
Critical objectives and responsibilities
- Strategic thinking
- Leading with Influence
- 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 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 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 Speciality Claims Standard Operations Procedures.
Experience, knowledge & skills required
- Matric
- 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: Is able to understand, identify and acts on broader opportunities in order to drive longer term, value-adding change. Applies judgement 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 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.
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