Claims Manager/risk Manager
6 months ago
Risk Manager specializing in the Healthcare Industry. This RM will be overseeing a team for claims management and claims consulting. Employee will have oversight of Risk Management policies and procedures and streamline the implementation and training of company employees. Employee should be knowledgeable in investigating and evaluating claims, determining the validity of claims, and negotiating settlements with claimants. This Employee will work closely with medical professionals, legal teams, and other stakeholders to ensure that claims are processed efficiently and effectively.
**Responsibilities;**
The job duties of a Senior Workers Compensation Claims Adjuster may include:
- Investigating and evaluating workers compensation claims
- Claims Management:
- On Site Safety Training
- Claims Investigation (includes emergency investigations)
- Compensability Determination
- Settlement Negotiation
- Litigation
- Reserve review
- Return to work program
- Subrogation
- Communicating with employers and insurance carriers to ensure that claims are processed in a timely and accurate manner
- Claims consulting teams:
- Claims oversight and management.
- Best practice and analysis.
- Book of business (carrier/client) reviews and trends.
- Loss control and recommendation process.
- Maintaining accurate records of claims and related documentation
- Staying up-to-date with changes in workers compensation laws and regulations
- Participating in training and professional development activities to enhance skills and knowledge
**Qualifications**
To be successful in this role, the Risk Manager should have strong analytical and problem-solving skills, excellent communication and negotiation skills, and the ability to work independently and as part of a team. They should also have a thorough understanding of workers compensation laws and regulations, as well as experience working with medical professionals and legal teams.
A bachelor's degree in a related field or relevant professional certifications (CSP, ARM, RRE) is required.
Working hours: 3pm - 11pm SA time
-
Manager (Pre-auth and Claims Department)
8 months ago
Johannesburg, South Africa National Risk Managers (Pty) Ltd Full timeA Medical Insurance company based in Benoni is looking for a Manager to Manage the Pre-Auth and Claims department. The Manager will manage the accurate and timely processing of claims within established legal and company compliance guidelines. Manage the pre-authorisation department and facilitate the process of pre-authorisation as per requests from members...
-
Risk Claims Assessor
1 month ago
Johannesburg, South Africa FirstRand Full timeJob Description Hello Future Risk Claims Assessor, Welcome to FNB, the home of the #changeables. We design for the shapeshifters and deliver products and services that make us incredibly proud of people that make it happen. As part of our team in FNB Life Assurance you will be surrounded by unique talents, diverse minds, and an adaptable environment that...
-
Claims Service Advisor
1 month ago
Johannesburg, Gauteng, South Africa Aon Full timeAt Aon, we're seeking a Claims Service Advisor to join our Risk Solutions department. This hybrid role offers the flexibility to work both virtually and from our Sandton office.The Claims Service Advisor will be responsible for managing the claims process from registration to finalization. This includes providing claims services to clients, specifically...
-
Senior Claims Manager
2 weeks ago
Johannesburg, South Africa Armstrong Appointments Full timeOur client is seeking a hands-on high-level Senior Claims Manager that will be based in Johannesburg, South Africa, responsible for the professional handling of a broad portfolio of general property, engineering, mining, casualty / financial lines claims, underwritten in both retail and international wholesale markets. The position reports into the Head of...
-
Claims Service Advisor
2 months ago
Johannesburg, Gauteng, South Africa Aon Full timeClaims Service Advisor Opportunity at AonAon is seeking a skilled Claims Service Advisor to join our Risk Solutions department. As a Claims Service Advisor, you will play a critical role in managing the claims process from registration to finalization.Key Responsibilities:Provide claims services to clients, including claims administration and resolving...
-
Senior Claims Manager
3 months ago
Johannesburg, South Africa Armstrong Appointments Full timeOur client is seeking a hands-on high-level Senior Claims Manager that will be based in Johannesburg, South Africa, responsible for the professional handling of a broad portfolio of general property, engineering, mining, casualty / financial lines claims, underwritten in both retail and international wholesale markets. The position reports into the Head of...
-
Senior Claims Manager
3 months ago
Johannesburg, South Africa Armstrong Appointments Full timeOur client is seeking a hands-on high-level Senior Claims Manager that will be based in Johannesburg, South Africa, responsible for the professional handling of a broad portfolio of general property, engineering, mining, casualty / financial lines claims, underwritten in both retail and international wholesale markets. The position reports into the Head of...
-
Risk Claims Assessor
3 months ago
Johannesburg, South Africa FirstRand Full timeJob Description - Manage costs / expenses within approved budget to achieve cost efficiencies - Analysis of financial transactions and statements to forecast potential write-offs of claims - Deliver exceptional service that exceeds customers’ expectations through proactive, innovative and appropriate solutions - Maintenance of expert knowledge on relevant...
-
Team Manager Claims Assessment
6 months ago
Johannesburg, South Africa PPS Recruitment Full time**Job Advert Summary**: A leadership role in the Life Operations team reporting to the Claims Manager. This role is responsible for managing a team responsible for assessing Sickness, Permanent Incapacity and Disability Claims as well as Case/Claims Management of ongoing claims. Ensure best practice and supporting the company in meeting its...
-
Senior Claims Manager
1 month ago
Johannesburg, South Africa Armstrong Appointments Full timeOur client is seeking a hands-on high-level Senior Claims Manager that will be based in Johannesburg, South Africa, responsible for the professional handling of a broad portfolio of general property, engineering, mining, casualty / financial lines claims, underwritten in both retail and international wholesale markets. The position reports into the Head of...
-
Claims Examiner
2 months ago
Johannesburg, Gauteng, South Africa AIG Full timeClaims Examiner Job DescriptionWe are seeking a skilled Claims Examiner to join our team at AIG. As a Claims Examiner, you will be responsible for providing efficient and professional claims service to customers through prompt and fair settlement of claims within mandate.Key Responsibilities:Claims Administration: Register claims according to procedure, set...
-
Claims Management Specialist
1 month ago
Johannesburg, Gauteng, South Africa Planned Talent Pty (Ltd) Full timeSenior Claims OfficerPlanned Talent Pty (Ltd) is seeking a highly experienced Senior Claims Officer to oversee the management of reinsurance claims, ensuring accuracy, compliance, and efficient handling of claim processes.This role requires strong expertise in claims administration and a deep understanding of the reinsurance sector, as well as excellent...
-
Operational Manager: Claims
6 months ago
Johannesburg, South Africa PPS Recruitment Full time**Job Advert Summary**: This is a senior position reporting to the CFO. This role will oversee the claims department responsible for the assessment and processing of Death, Sickness, Critical Illness and Hospital claims. If you have extensive experience in claims assessment in a life company, self-driven, confident to handle complex claims issues, possess...
-
Claims Manager
6 months ago
Johannesburg, South Africa Insphired Recruitment Solutions Full timeOur client in the Insurance industry is currently looking for a **Claims Manager** in Park Town, Johannesburg. **Responsibilities**: - Day to day management of staff. - Delegate and distribute workload as required. - Appraise and review performance targets/progress. - Staff recruitment and selection. - Manage efficiencies in department. - Claims strategy -...
-
Risk Management Specialist
1 month ago
Johannesburg, Gauteng, South Africa Planned Talent Full timeSenior Claims Officer RoleOur client, a leader in the global reinsurance industry, is seeking a highly experienced Senior Claims Officer to join their team. As a Senior Claims Officer, you will be responsible for overseeing the management of reinsurance claims, ensuring accuracy, compliance, and efficient handling of claim processes. This role requires...
-
Claims Operations Manager
8 months ago
Johannesburg, South Africa AIG Full timeThe Claims Operations Manager - South Africa, will report to the EMEA Head of Claims Operations with a matrix to the South Africa Head of Claims. This role will be responsible for claims governance & compliance, process optimization & continuous improvement, strategic execution, project delivery, claims system initiatives and where required, coordinate with...
-
Claims Relationship Manager
4 months ago
Johannesburg, South Africa Aon Corporation Full timePosting Description: **Claims Relationship Manager** Extensive marine/mining claims management experience? Good with clients? Read on! Aon South Africa is recruiting a Claims Relationship Manager, based in the Claims Advocacy department at our offices in Sandton. This is a hybrid role. The role of the CRM is to maintain the relationship between the Aon...
-
Claims Relationship Manager
6 months ago
Johannesburg, South Africa Aon Corporation Full timePosting Description: **Claims Relationship Manager**: Extensive claims management experience? Good with clients? Read on! Aon South Africa is recruiting a Claims Relationship Manager, based in the Claims department at our offices in Sandton. This is a hybrid role. The role of the CRM is to maintain the relationship between the Aon claims department, the...
-
Claims Relationship Manager
6 months ago
Johannesburg, South Africa Aon Corporation Full timePosting Description: **Claims Relationship Manager** Extensive claims management experience? Good with clients? Read on! Aon South Africa is recruiting a Claims Relationship Manager, based in the Claims department at our offices in Sandton. This is a hybrid role. The role of the CRM is to maintain the relationship between the Aon claims department, the...
-
Claims Consultant
6 months ago
Johannesburg, South Africa Munich Re Full timeClaims Consultant Career Level 3 **Company** Munich Re **Location** Johannesburg, South Africa **Your Business Unit**: Our Life Claims Management team mitigates risk at claim stage. We collaborate across the various Life business units, including Underwriting, Product & Pricing, Chief Medical Office and Marketing. **Your Team**: Our Life Claims...