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Claims Specialist
2 weeks ago
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 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
- All Claims Departments
- Sales
- Underwriting.
External
- Brokers
- Clients
- All Claims Suppliers
- Service Providers
Qualifications & Experience
- 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 :07 March 2024
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