Claims Controller

3 weeks ago

Johannesburg, South Africa Boikago Group Full time

**Job Details**:

- Department Insurance- Minimum experience Associate- Company primary industry Insurance- Job functional area Other**Introduction**

A great company in the insurance sector is actively sourcing for a Claims Controller to join their team for a 6 months fixed term contract and accurately record and examine received claims and any related documentation thereof, to perform document diary maintenance on IMS system, capture claims received by the department on register for reserve and keep a regular follow-up outstanding reserve once claims are verified by Claims Manager**Purpose of the Role**

The Claims Controller will collate records and examine information to assist in determining claim settlements, within the governed framework to ensure compliance with the short-term insurance regulations or determine the validity of the claims from agent companies, assess the liability and negotiate settlements.**Key Responsibilities**:
**1. Claims processes**
- Accurately record and examine received claims and any related documentation thereof
- Perform document diary maintenance on CMS system
- Assess claims received by the department to reserve and keep a regular follow-up outstanding reserve once claims are verified by Claims Manager
- Approve claims within delegated authority after verification of all documents and validation thereof under the policy cover
- Escalate complex claims to Supervisor
- Assist in the extrapolation of monthly reports on claims

**2. Agency/ Broker Liaison**
- Inform underwriting department of gaps in cover and/or wording documents as well as adjustors such as losses/ gains on premium
- Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim
- Negotiate the settlement and disposition of claims within prescribed mandate; interpret related claims documentation

**3. Perform ad hoc tasks**
- Perform any reasonable tasks as and when required by the Line Manager

**Minimum experience & qualifications required**

**Qualifications**:

- Higher Certificate in Insurance NQF5 (preferable)
- Tertiary education (preferable)

**Experience**:

- 3 - 5 years’ experience in a Claims position of short-term Insurance company

**Perform Ad Hoc tasks**
- Perform any reasonable tasks as and when required by the Line Manager
- ApplyA great company in the insurance sector is actively sourcing for a Claims Controller to join their team for a 6 months fixed term contract and accurately record and examine received claims and any related documentation thereof, to perform document diary maintenance on IMS system, capture claims received by the department on register for reserve and keep a regular follow-up outstanding reserve once claims are verified by Claims Manager

**Purpose of the Role**

The Claims Controller will collate records and examine information to assist in determining claim settlements, within the governed framework to ensure compliance with the short-term insurance regulations or determine the validity of the claims from agent companies, assess the liability and negotiate settlements.

**Key Responsibilities**:
**1. Claims processes**
- Accurately record and examine received claims and any related documentation thereof
- Perform document diary maintenance on CMS system
- Assess claims received by the department to reserve and keep a regular follow-up outstanding reserve once claims are verified by Claims Manager
- Approve claims within delegated authority after verification of all documents and validation thereof under the policy cover
- Escalate complex claims to Supervisor
- Assist in the extrapolation of monthly reports on claims

**2. Agency/ Broker Liaison**
- Inform underwriting department of gaps in cover and/or wording documents as well as adjustors such as losses/ gains on premium
- Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim
- Negotiate the settlement and disposition of claims within prescribed mandate; interpret related claims documentation

**3. Perform ad hoc tasks**
- Perform any reasonable tasks as and when required by the Line Manager

**Minimum experience & qualifications required**

**Qualifications**:

- Higher Certificate in Insurance NQF5 (preferable)
- Tertiary education (preferable)

**Experience**:

- 3 - 5 years’ experience in a Claims position of short-term Insurance company

**Perform Ad Hoc tasks**
- Perform any reasonable tasks as and when required by the Line Manager

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