Claims Specialist

3 weeks ago


Johannesburg, South Africa HR CAPITAL RECRUITMENT PTY Ltd Full time

**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)


  • Claims Specialist

    3 weeks ago


    Johannesburg, South Africa HumanTouch Recruitment Full time

    **Claims Specialist** An insurance company has a new position available for a Claims Specialist: Liability who will be based in Johannesburg - Illovo. **Minimum Requirements** - Experience 2 years in Liability / PI claims (handling at an insurer or litigation at an attorney firm) - Matric - Legal qualification required **Duties** Claims Practice...


  • Johannesburg, South Africa Ultra Personnel Full time

    Matric (Grade 12) is essential FETC (Further Education & Training Certificate) in Short Term Insurance NQF 4 (150 credits) Higher Certificate in Short Term Insurance : NQF 5 or higher is highly advantageous Successfully passed RE 5 Class of Business certification (Personal Lines & Commercial Lines) Highly advantageous Must be compliant with FAIS Fit and...

  • Claims Specialist

    3 days ago


    Johannesburg, Gauteng, South Africa Hollard Full time

    Hollard Insure is looking to recruit a Claims Specialist for a 12 months graduate programme in our Specialised Claims Services Department (Operations).The role involves learning how to manage the end-to-end negotiation and settlement of Third Party Claims, pre litigation by ensuring operational efficiencies and quality service delivery. Key responsibilities...


  • Johannesburg, South Africa Santam Full time

    What will you do? This career opportunity is available at SHA Risk Specialists, a division of Santam for a Claims Specialist: Casualty Claims, who will be based in Johannesburg, Illovo. What will make you successful in this role? Claims Practice Management Attend and manage all aspects related to a portfolio of specialist claims such as claims...


  • Johannesburg, Gauteng, South Africa Qetello Holdings Full time

    As a Medical Claims Specialist with Qetello Holdings in Johannesburg, you will play a crucial role in assisting our client, a leading claims administrator in the area, with Private and medical aid claims.Key ResponsibilitiesImplement credit control procedures for specialist doctors and Allied Professionals in accordance with our credit control/debt...


  • Johannesburg, South Africa CIB PTY (LTD) Full time

    **Main purpose of the role**: The main purpose of the Claims Specialist's role is to validate and administer a client's motor claim following a fortuitous event. In accordance with Standard Operating Procedures, claims guidelines, the specialist own mandate, and the client's policy schedule, the specialist will make a claims settlement...


  • Johannesburg, Gauteng, South Africa Zensar Technologies Full time

    We are looking for a skilled Claims Assessment Specialist to join our team at Zensar Technologies. As a Claims Assessor, you will provide specialist advice and support in the generation and provision of reliable claims assessment activities.The ideal candidate will have a strong understanding of insurance products and services, as well as the ability to...

  • Claims Specialist

    11 hours ago


    Johannesburg, South Africa Kaelo Full time

    Company Description Kaelo provides **essential healthcare solutions** ensuring the **physical and psychosocial wellbeing** of **all South Africans** towards **lasting social change**. **Job Description**: The Claims Specialist manages the assessment of claims and has specialised knowledge of the claims environment. There is a strong focus on accurately and...


  • Johannesburg, South Africa HR CAPITAL RECRUITMENT PTY Ltd Full time

    **MOTOR CLAIMS SPECIALIST** required for a well-established insurance company based on the East Rand to validate and administrate motor claims in accordance with Standard Operating Procedure, claims guidelines, the specialist’s own mandate, and the client’s policy schedule. **Minimum Requirements**: - Matric (Grade 12) - essential - FETC (Further...


  • Johannesburg, South Africa Marsh Full time

    **Specialist Claims Advisor**: **What can you expect?** Marsh is a global leader in **insurance broking** and innovative risk management solutions. We help clients quantify and manage risk and help them unlock new growth opportunities. Having an established presence in more than 130 countries worldwide, national and international collaboration and...


  • Johannesburg, Gauteng, South Africa Santam Insurance Full time

    Job Description:We are seeking a skilled Property Claims Specialist to join our team in Centurion. The successful candidate will be responsible for determining the quantum and merit of non-motor claims by performing investigations, verifying event descriptions, negotiating with clients and intermediaries, and settling claims within delegated thresholds.The...

  • Claims Specialist

    3 weeks ago


    Johannesburg, Gauteng, South Africa Santam Insurance Full time

    Job title : Claims Specialist : Technical Trainer JHB (JG7)Job Location : Gauteng, JohannesburgDeadline : March 07, 2025Quick Recommended LinksJobs by Location Job by industries KEY RESPONSIBILITIESProvide ongoing Technical and Operational training (technical, claims procedure for existing staff and new appointments) as required. Ensure compliance to...


  • Johannesburg, Gauteng, South Africa Energy at Work Full time

    Energy at Work seeks a skilled Claims Management Specialist to join our team. As a Claims Conqueror Extraordinaire, you will be responsible for registering and managing claims with accuracy and flair.Key Responsibilities:Register claims with the highest level of precision and speed.Negotiate with suppliers and adjustors to ensure seamless claim...

  • Claims Specialist

    3 weeks ago


    Johannesburg, South Africa Antal Full time

    **Claims Specialist **(non-motor liability)** - JHB** We are looking to connect with Claims professionals with a minimum of 1 - 5 year’s non-motor liability experience. Our client is a leading insurance company based in Johannesburg and is in need of a Claims Specialist who will be responsible for attending and managing all aspects related to a portfolio...


  • Johannesburg, South Africa Kaelo Full time

    Company Description **About Kaelo** Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa - products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and...


  • Johannesburg, Gauteng, South Africa Tower Group (Pty) Ltd Full time

    Job SummaryAt Tower Group (Pty) Ltd, we seek a skilled Claims Specialist to join our team in Johannesburg. As a key member of our organization, you will be responsible for resolving claims and providing exceptional customer service.About the RoleThis is a challenging opportunity for an experienced professional to utilize their technical skills and...


  • Johannesburg, Gauteng, South Africa Energy at Work Full time

    Claims Conqueror Job SummaryWe are looking for an Insurance Claim Specialist to join our team at Energy at Work. This is an exciting opportunity for a skilled and enthusiastic individual who thrives in the world of claims management.About the Role:As a Claims Conqueror, you will register claims with flair, negotiate effectively, finalize claims smoothly,...


  • Johannesburg, Gauteng, South Africa Santam Insurance Full time

    Stay safe online. Now more than ever it's important to be cybersafe.Santam, the market leader in the general insurance industry in Southern Africa, is seeking a skilled Claims Investigator Specialist to join our team.About the JobConduct comprehensive investigations of flagged and segmented claims to achieve conclusive results.Maintain credibility by...


  • Johannesburg CBD, South Africa Rand Mutual Admin Services Full time

    **Job Overview**Rand Mutual Admin Services is seeking a skilled Clinical Claims Specialist to join our team. In this role, you will be responsible for providing critical support in the effective and efficient adjudication of disease and accident claims.About the RoleReview and update ICD10 codes on all claims in line with relevant protocols and accepted...


  • Johannesburg, South Africa Santam Full time

    What will you do? This career opportunity is available at SHA Risk Specialists a division of Santam for a Claims Specialist: Motor, who will be based in Johannesburg, Illovo. What will make you successful in this role? Claims Portfolio Attend to all aspects related to a portfolio of claims e.g. new claims, current files, diary, mail, recoveries, third...