Claim Specialist

2 weeks ago

Johannesburg, South Africa Bryte Insurance Full time

Who We Are

The purpose of the function is to attend to the adjustment and management of claims with the aim of minimising the losses due to the company and approving only those claims that we are truly liable.

Key Tasks & Accountabilities
- Prioritise daily activities to enable processing and maintenance of all claims.
- Within Mandate
- Check the accuracy of registered claims cover details and add claimant details timeously.
- Confirm estimate is accurate, deducting excess to work out estimate of claim through investigating policy cover.
- Complete fraud list and Identify claims that requires further fraud verification.
- Ensure computer generated letter is forwarded to relevant broker.
- Liaise with stakeholders to gather and ensure accuracy of information.
- If required, inform other relevant departments within claims (e.g. recoveries, salvages, claims verification units etc)
- Capture diary entry immediately after registration process, describing progress and action of claim.
- Deal with and ensure resolution of queries on an on-going basis.
- Obtain necessary documents/assessors report and make amendments to estimates ensuring authorization within policy cover.
- Continually update and maintain diary system.
- Draw payment on relevant system, ensuring accuracy of banking details, invoice number, VAT numbers, class allocation, client release, etc.
- Ensure letters are forwarded to brokers demonstrating breakdown of payments.
- Ensure accurate codes are allocated to payment of claims to minimize leakage.
- Finalize payments on Workflow (Within Mandates)
- Review all open files on a quarterly basis by assessing check reports and claims not processed report (Estimate Review)
- If encounter system problems, log calls timeously with relevant department

Effective customer focus and service
- Liaise with internal stakeholders to facilitate problem resolution and efficiency of work activities.
- Communicate with stakeholders on a daily basis to inform of progress of claims and claim policy and procedure.
- Deal with and resolve any queries relevant to area; if unable to resolve, escalate to manager for resolution
- Represent the organization through maintaining high levels of professionalism, service excellence and customer excellence.
- Adhere to internal policies, processes, and procedures.

Effective adherence to company claims policy, standards, and SLA.
- Ensure adherence to all company policies at all times.
- Ensure adherence to negotiated flexi hours.
- Maintain dress code, behaviour, and absenteeism.

Relationships

Internal Relationship
- All Claims Departments
- Sales
- Underwriting.

External Relationship
- Brokers (Telephonically and Directly)
- Clients
- All Claims Suppliers
- Service Providers

Experience & Qualifications
- Minimum Degree or NQF Level 4
- Minimum 5 years claims handling/ adjustment experience.
- Proven experience in handling of large loss claims, especially cases valued over R1,000,000.00 in Property/ Business Interruption claims.
- Relevant experience of managing service providers, negotiation, and face to face meetings with stake holders.
- Sound knowledge, experience and understanding of short-term insurance.
- General Claims Handling skills
- Understanding of Bryte guiding principles and philosophy and framework
- Applications of claims technical guidelines
- Basic insight into company strategies and business plans
- Clear understanding of Financial Services compliance framework
- Sound knowledge of Bryte organizational structure
- In-depth knowledge and understanding of relevant company policies, processes, and procedures.
- Sound internal network.
- Knowledge of relevant workflow systems

Other Requirements
- Accuracy
- Attention to detail.
- Customer service orientation (including assertiveness)
- Oral and written communication
- Planning and organizing
- Problem solving
- Self-awareness
- Teamwork
- Work standards.
- Guiding Principals

Technical Skills
- Computer and system skills
- Administrative skills
- Telephone skills.
- Communication skills
- Negotiation

Closing date:01 April 2024

  • Motor Claims Specialist

    1 week ago

    Johannesburg, South Africa Ultra Personnel Full time

    Matric (Grade 12) is essential FETC (Further Education & Training Certificate) in Short Term Insurance NQF 4 (150 credits) Higher Certificate in Short Term Insurance : NQF 5 or higher is highly advantageous Successfully passed RE 5 Class of Business certification (Personal Lines & Commercial Lines) Highly advantageous Must be compliant with FAIS Fit and...

  • Claims Specialist

    Found in: beBee S ZA - 4 weeks ago

    Johannesburg, South Africa Jobking Full time

    CLAIMS SPECIALIST: NON-LIFE CLAIMS (LEVEL C1) Munich Reinsurance Company of Africa Limited (MRoA) has been operating in South Africa for 50 years, although the Munich Re (Group) was active on the Continent via Munich Re in Munich for some years prior to commencing the Southern African operation in Johannesburg in 1968. The Head Office of MRoA is in...

  • Claims Specialist

    Found in: beBee S ZA - 2 weeks ago

    Johannesburg, South Africa Jobking Full time

    CLAIMS SPECIALIST: NON-LIFE CLAIMS (LEVEL C1) Munich Reinsurance Company of Africa Limited (MRoA) has been operating in South Africa for 50 years, although the Munich Re (Group) was active on the Continent via Munich Re in Munich for some years prior to commencing the Southern African operation in Johannesburg in 1968. The Head Office of MRoA is in...

  • Non Motor Claims Specialist

    Found in: Talent ZA C2 - 2 weeks ago

    Johannesburg, South Africa Manpower Group SA (Pty) Ltd Full time

    The main purpose of the Claims Specialist’s role is to validate and administrate a client’s claim following a fortuitous event. The claims specialist will be responsible for various Non-Motor Claims. Claims settlement determinations are made in accordance with Standard Operating Procedure, claims guidelines, the specialist own mandate, and the client’s...

  • Business Claims Specialist

    14 hours ago

    Johannesburg, South Africa Deka Minas (Pty) Ltd Full time

    One of our leading clients offering comprehensive financial solutions that include bond pre-approvals, home loans, short-term insurance, life insurance and more through its various subsidiaries is looking to build their Dream team with the Right People. JOB PURPOSE: As Business Claims Specialist you will provide support to the Product Manager, reviewing...

  • Claims Specialist

    Found in: beBee jobs ZA - 1 week ago

    Johannesburg, Gauteng, South Africa Jobking Full time

    CLAIMS SPECIALIST:NON-LIFE CLAIMS (LEVEL C1)Munich Reinsurance Company of Africa Limited (MRoA) has been operating in South Africa for 50 years, although the Munich Re (Group) was active on the Continent via Munich Re in Munich for some years prior to commencing the Southern African operation in Johannesburg in 1968. The Head Office of MRoA is in...

  • Binder and Outsourced Claims Specialist

    2 weeks ago

    Johannesburg, South Africa Ultra Personnel Full time

    Matric Certificate and Regulatory Exams Further Education and Training Certificate in Short-Term Insurance NQF 4, and/ or a Higher Certificate in Short term Insurance - NQF 5 Class of Business certification (Personal Lines & Commercial Lines) Highly advantageous Must be compliant with FAIS Fit and Proper requirements with track-record of working...

  • Claims Specialist: Liability

    2 days ago

    Johannesburg, South Africa Santam Full time

    What will you do? This career opportunity is available at SHA Risk Specialists a division of Santam for the Claims Specialist: PI, who will be based in Johannesburg, Illovo. What will make you successful in this role? Claims Practice Management Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case...

  • Health Claims Specialist

    1 week ago

    Johannesburg, South Africa Kaelo Full time

    Company Description **About Kaelo** Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa - products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and...

  • Senior Non-motor Claims Specialist

    2 weeks ago

    Johannesburg, South Africa Ultra Personnel Full time

    Matric Certificate and Regulatory Exams Further Education and Training Certificate in Short-Term Insurance NQF 4, and / or a Higher Certificate in Short term Insurance - NQF 5 Class of Business certification (Personal Lines & Commercial Lines) Highly advantageous Must be compliant with FAIS Fit and Proper requirements with track-record of working...

  • Claims Specialist: Motor

    2 days ago

    Johannesburg, South Africa Santam Full time

    What will you do? This career opportunity is available at SHA Risk Specialists a division of Santam for a Claims Specialist: Motor, who will be based in Johannesburg, Illovo. What will make you successful in this role? Claims Portfolio Attend to all aspects related to a portfolio of claims e.g. new claims, current files, diary, mail, recoveries, third...

  • Claims Assessor Specialist

    6 days ago

    Johannesburg, South Africa FirstRand Full time

    Job Description Dear Future, Claims Assessor Specialist Are you someone who can: - Accurate assessment, investigation and management of long-term insurance claims including disability (temporary or permanent disability) and critical illness claims. - Ensuring that the claims assessment and that the standard of decision is consistent with the company...

  • Gap Claims Specialist

    5 days ago

    Johannesburg, South Africa Kaelo Full time

    Company Description Kaelo provides **essential healthcare solutions** ensuring the **physical and psychosocial wellbeing** of **all South Africans** towards **lasting social change**. **Job Description**: The Claims Specialist manages the assessment of claims and has specialised knowledge of the claims environment. There is a strong focus on accurately and...

  • Claims Assessors

    Found in: Adzuna ZA B C2 - 1 week ago

    Johannesburg, South Africa Adzuna ZA B C2 Full time

    A leader in the Insurance field is on the look out for Claims Assessors to form part of their Team. This person will provide specialist advise and support in the generation and provision of reliable claims assessment activities, to support key deliverables and informed decision making, through the execution of predefined objectives as per agreed...

  • Claims Assessors

    Found in: Talent ZA 2A C2 - 1 week ago

    Johannesburg, South Africa Planet10 Full time

    A leader in the Insurance field is on the look out for Claims Assessors to form part of their Team. This person will provide specialist advise and support in the generation and provision of reliable claims assessment activities, to support key deliverables and informed decision making, through the execution of predefined objectives as per agreed...

  • Claims Assessors

    Found in: Whatjobs ZA C2 - 5 days ago

    Johannesburg, South Africa Planet10 Full time

    A leader in the Insurance field is on the look out for Claims Assessors to form part of their Team.  This person will provide specialist advise and support in the generation and provision of reliable claims assessment activities, to support key deliverables and informed decision making, through the execution of predefined objectives as per agreed SOPs....

  • Senior Pi Claims Assessor

    14 hours ago

    Johannesburg, South Africa PPS Recruitment Full time

    **Job Advert Summary**: This role reports to the Team Manager Claims. Responsible for assessment and management of long-term Sickness, Permanent Incapacity and Disability claims. The role will transfer specialist claims knowledge, in-depth process knowledge and client centric principles. The incumbent will deal with technical and complex claims queries...

  • Short Term Insurance Claims Data Specialist

    2 days ago

    Johannesburg, South Africa Absa Bank Limited Full time

    Bring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job Summary Short...

  • Claims Specialist

    6 days ago

    Johannesburg, South Africa Bryte Insurance Full time

    Who We Are Key Tasks & Accountabilities - Prioritise daily activities to enable processing and maintenance of all claims - Within Mandate - Check the accuracy of registered claims cover details and add claimant details timeously - Confirm estimate is accurate, deducting excess to work out estimate of claim through investigating policy cover - Complete fraud...

  • Claims Manager: Specialist Liability

    5 days ago

    Johannesburg, South Africa Sanlam Full time

    OPPORTUNITY- Santam’s Legal Claims Solutions department has a position available for a Claims Manager: Specialist Liability that will be based in Alice Lane, Sandton.- WHAT WILL YOU DO?- The primary purpose of this position is to effectively deal with personal legal liability and public liability claims, end to end.- The responsibilities will include...