Insurance Claims Validator and Coach

20 hours ago


Johannesburg, Gauteng, South Africa Manpower Group SA (Pty) Ltd Full time
Job Summary

We are seeking an experienced Insurance Claims Validator and Coach to join our team at Manpower Group SA (Pty) Ltd. The successful candidate will be responsible for validating and processing short-term insurance claims, as well as coaching and guiding binder and outsource brokers to make correct claims validation determinations.

The ideal candidate will have a strong understanding of short-term insurance policy wording, excellent technical knowledge, and the ability to work independently with minimal supervision. This role requires a high level of professionalism, attention to detail, and effective communication skills.

Key Responsibilities:
  • Validate and process short-term insurance claims in line with company guidelines and standard operating procedures.
  • Manage large loss and complex claims, including appointment of necessary providers and authorizations/settlement of claims.
  • Rejection of claims and processing payments within turnaround time.
  • Assist clients and brokers over the phone/email with claims and queries.
  • Maintain relationships with allocated brokers, including training and oversight.
  • Handle complaints and resolve issues efficiently.
  • Liaise with service providers and brokers to ensure smooth claim processing.


Requirements

To be successful in this role, you will need to possess the following qualifications and experience:

  • Matric Certificate – essential.
  • Regulatory Exam.
  • Further Education and Training Certificate in Short-Term Insurance – NQF 4, or Higher Certificate in Short term Insurance - NQF 5.
  • Class of Business certification (Personal Lines & Commercial Lines) – highly advantageous.
  • FAIS Fit and Proper requirements with a track-record of working unsupervised.
  • Marine and Engineering knowledge – highly advantageous.
  • Computer literacy – Microsoft Word, Excel, and Outlook.
  • At least 5-10 years' relevant work experience in claims validations and settlement, including Motor and Non-Motor claims, Personal Lines, and Commercial Lines classes of business.
  • Work experience within a licensed insurer or Underwriting Manager.
  • Experience making claims settlement determinations with mandate exceeding R250 000.00.
  • Sound technical knowledge and understanding of relevant short-term insurance policy wording.


Compensation and Benefits

We offer a competitive salary package, estimated at R600,000 per annum, based on market standards and location. Additionally, we provide benefits such as medical aid, retirement funding, and annual leave. If you are a motivated and experienced professional looking for a new challenge, please submit your application.

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