Claims Settlement Specialist

4 days ago


Sandton, South Africa HR Genie Full time

**About HR Genie**

We are a leading company in the insurance industry, and we are seeking a skilled Claims Settlement Specialist to join our team.

**Salary:** $65,000 - $85,000 per annum

**Job Description:**

Key Responsibilities:
  • Claims Handling:
    • Maintain high standards of claims settlement and provide excellent customer service.
    • Register and manage claims for personal and commercial policies.
    • Appoint assessors and ensure sufficient cover.
    • Settle claims efficiently and accurately update data systems.
    • Manage claims from start to settlement stage.
    • Gather information from clients and involved parties.
    • Examine claim details and check against policy cover.
    • Consult with staff to decide claim outcomes and compensation.
    • Inform clients of claim outcomes in writing.
    • Refer complex claims to professionals like loss adjusters.
    • Determine claim merits based on facts and investigations.
    • Settle claims within parameters to avoid leakage.
    • Obtain necessary information for settlement or rejection.
    • Adjust reserves continuously.
    • Arrange car hire for insured clients in accidents.
    • Deal with contractors for critical documents.
    • Manage salvage processes.
    • Negotiate claims with clients, service providers, and insurers.
    • Keep detailed file notes of discussions.
    • Negotiate contentious claims with insurers and clients.
    • Refer potential errors to Claims Manager.
    • Complete claim files upon finalisation and file to EDS.
    • Maintain claims files according to operational standards.
    • Update systems daily.
    • Promptly handle complaints and queries.
    • Ensure speedy resolution of queries and complaints.
    • Submit insurer feedback and reports as agreed.
    • Provide a pleasant claims experience.
    • Foster sound relationships with clients, colleagues, markets, and service providers.
    • Maintain policy updates after claims.
    • Update underwriting items for deletion or replacement.
    • Record reports submitted to clients.
People Skills:
  • Service Delivery:
    • Ensure customer satisfaction through service delivery.
    • Maintain service quality and desired outputs within specific processes.
    • Resolve escalated customer queries and complaints.
    • Develop work routines to achieve service delivery goals.
    • Share knowledge on new standards and procedures.
Technology:
  • Continuous Improvement:
    • Adhere to organisational policies and procedures.
    • Identify areas for process improvement.
    • Recommend improvements.
    • Confirm DOFA compliance.
    • Experience with Cardinal 360 system is an advantage.


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