Binder & Outsourced Claims Specialist
2 weeks ago
**Job Number**
- 68924
**Job Type**
- Permanent
**Job Title**
- Binder & Outsourced Claims Specialist
**Computer Skills**
- MS Excel,MS Outlook,MS Word,TIAL
**Industry**
- Insurance - Brokering
**City**
- Johannesburg
**Province**
- Gauteng
- Validation of claims in line with Company guidelines and Standard Operating Procedures
- Appointment of necessary providers
- Authorizations\Settlement of claims
- Rejection of claims
- Processing payments within the turn-around time
- Payment confirmations to Brokers and Suppliers
- Relationship Management with allocated brokers, including training of brokers with outsource agreements
- Complaints handling and resolution
- Liaising with Service Providers
- Liaising with brokers and clients
**Core Competencies Required**
- Ability to plan and prioritise own time and work commitments to deliver timeous claims service within agreed turn-around times
- Ability to take initiative and respond pro-actively and independently to situations to secure positive results
- Accepts ownership and accountability for one’s own actions and decisions
- Is open to learning opportunities and is committed to continuous self-development
- Ability to communicate openly, and with impact
- Ability to adapt one’s communication style and content to the audience and context.
- Ability to easily connect with others and develop professional relationships and partnerships with others
- Strong listening skills
- Demonstrate high levels of customer centricity and empathy
- Effective numerical skills and ability to think analytically with good attention to detail
- Solution based thinking
- Problem solving ability
- High levels of self-perception (confidence, self-empowerment, optimism, self-respect)
- Ability to function independently, demonstrating good control and composure under pressure
- Must have high inner values of Honesty, Integrity and reliability**Inherent Requirements**
- Matric Certificate - essential
- Regulatory Exam
- 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)
- Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised.
**MINIMUM OTHER TRAINING REQUIRED**
- Computer literate - Microsoft Word, Excel, and Outlook
- Experience working on TIAL - highly advantageous
- Experience in Commercial and Personal lines
**MINIMUM YEARS OF FORMAL & INFORMAL TRAINING REQUIRED**
- At least 5-10 years relevant work experience in claims validations and settlement for both Personal Lines and Commercial Lines Non-Motor claims
- Work experience within a licensed insurer, or Underwriting Manager (UMA).
- Experienced in making claims settlement determinations with mandate exceeding R250 000
- Sound technical knowledge and understanding of relevant short term insurance policy wording
**What Qualification**
- Short-Term Insurance - NQF 4, and/ or a Higher Certificate in Short term Insurance - NQF 5
**Minimum Qualification**
- Certificate
**Status**
- Available
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