Claims Specialist
3 weeks ago
**NON-MOTOR CLAIMS SPECIALIST** required for a well-established insurance company based on the East Rand to validate and process short-term insurance claims following a fortuitous event. In accordance with Standard Operating Procedure, claims guidelines, the specialist own mandate, and the client’s policy schedule, the Claims Specialist will make a claims settlement determination on complex and high value Non
- Motor Claims
**Minimum Requirements**:
- Matric Certificate - essential
- Regulatory Exam (highly advantageous)
- Further Education and Training Certificate in Short-Term Insurance - NQF 4, and/ or a Higher
- Certificate in Short term Insurance - NQF 5 (highly advantageous)
- Must be compliant with FAIS Fit and Proper requirements with track-record of working
- unsupervised.
- Computer literate - Microsoft Word, Excel, and Outlook
- Experience working on TIAL - highly advantageous
- 1-2 years relevant work experience in claims validations and settlements
- Exposure to short term insurance claims administration highly advantageous
**Duties and Responsibilities**:
- Validation of claims in line with checklist and SOP’s
- Appointment of necessary providers
- Authorizations\Settlement of claims
- Rejection of claims
- Processing payments within the turn-around time
- Payment confirmations to Brokers and Suppliers
- Complaints handling and resolution
- Liaising with Service Providers
- Liaising with brokers and clients
**Skills Required**:
- Ability to function independently and under pressure
- Conflict resolution
- Excellent interpersonal and communication skills
- Assertiveness
- Deadline driven
- High attention to detail
- Proactive/ ability to use own Initiative/ Innovative
- Flexibility and adaptability to change.
- Computer literate.
- Effective Time management skills.
- Honesty, Integrity and reliability
- Teamwork
- Must be willing to complete studies (Insurance related)
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