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Claims Examiner

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Johannesburg, Gauteng, South Africa SavageOne Pty Ltd Full time
Job Title: Claim Handler

About the Role:

We are seeking a highly skilled and experienced Claim Handler to join our team at SavageOne Pty Ltd. As a Claim Handler, you will be responsible for handling insurance claims from initial receipt to final resolution, ensuring that all claims are processed efficiently and effectively.

Key Responsibilities:

  1. Review and assess insurance claims to determine coverage and eligibility.
  2. Conduct thorough investigations into the circumstances surrounding each claim, gathering relevant information, documents, and evidence.
  3. Evaluate claim documentation, policy terms, and legal regulations to determine the validity of claims and assess liability.
  4. Communicate with claimants, policyholders, witnesses, and other relevant parties to obtain additional information and clarify details of the claim.
  5. Provide clear and accurate explanations of coverage, claim decisions, and settlement options to claimants and policyholders.
  6. Process claims payments, settlements, and reserves in accordance with company policies and regulatory requirements.
  7. Negotiate settlement agreements with claimants or their representatives to achieve fair and equitable resolutions.
  8. Collaborate with internal departments, including underwriting, legal, and finance, to address complex claims issues and mitigate risk.
  9. Maintain detailed and organized claim files, documenting all relevant activities, communications, and decisions throughout the claims process.
  10. Stay current on industry trends, regulatory changes, and best practices in claims handling to enhance knowledge and performance.

Qualifications:

  1. Bachelor's degree in Business, Finance, Risk Management, or a related field is preferred.
  2. Proven experience in insurance claims handling or a related field with a strong understanding of insurance principles, policies, and procedures.
  3. Excellent analytical skills with the ability to evaluate information, assess risk, and make sound decisions.
  4. Strong communication and interpersonal skills with the ability to effectively interact with diverse stakeholders.
  5. Detail-oriented approach with a focus on accuracy and precision in claim documentation and processing.
  6. Ability to prioritize tasks, manage workload efficiently, and meet deadlines in a fast-paced environment.
  7. Proficiency in computer applications and claims management software.
  8. Knowledge of insurance regulations and compliance requirements.
  9. Strong negotiation skills with the ability to resolve conflicts and negotiate favorable outcomes.
  10. Commitment to providing exceptional customer service and building positive relationships with clients and colleagues.

Preferred Qualifications:

  1. Professional certification in claims adjusting or risk management (e.g., AIC, ARM) is a plus.
  2. Experience handling complex or high-value insurance claims.
  3. Familiarity with various types of insurance coverage, including property, casualty, and liability.
  4. Bilingual proficiency in languages commonly spoken by our client base may be advantageous.

What We Offer:

We offer a competitive salary, comprehensive benefits package, and opportunities for professional growth and development. If you are a motivated and experienced Claim Handler looking for a new challenge, please submit your application.