Accident & Health Claims Examiner

6 days ago


Johannesburg, South Africa AIG Full time

Provide an efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate.

Contribute to business development and retention through positioning Claims and Claims service as an AIG product

Provide an efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate.

Contribute to business development and retention through positioning Claims and Claims service as an AIG product

PRINCIPLE DUTIES AND RESPONSIBILITIES:
Claims Administration
- Register the Claim according to procedure
- Set appropriate reserves in line with policy
- Determine if the loss is covered in terms of the policy
- Assess the Claim based on accurate interpretation of policy wording in place: refer Claims outside Claims mandate
- Appoint / recommend appointment of loss adjusters and/or relevant experts: provide appropriate settlement instructions
- Follow Claims settlement process to ensure timely settlement of Claims and fees
- Conduct timely, professional follow-up correspondence with Clients and Brokers, including Claims rejection
- Provide reports to Claims Manager in line with Claims policies

Customer Service
- Establish and maintain excellent levels of customer service, with particular attention to:

- Responsiveness - speed of service delivery
- Quality of service rendered
- Adherence to internal and external SLA’s

Audit and Compliance
- Ensure adherence with and implementation of all claims compliance controls as may be specified from time to time by the Claims Manager

QUALIFICATIONS:

- Matric
- Short Term Insurance qualification preferred
- FAIS compliant

EXPERIENCE:

- Minimum of 3 years experience as Claims Examiner, including experience in specific Line of Business, as appropriate.

We are an Equal Opportunity Employer

American International Group, Inc., its subsidiaries and affiliates are committed to be an Equal Opportunity Employer and its policies and procedures reflect this commitment. We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories such as sexual orientation. At AIG, we believe that diversity and inclusion are critical to our future and our mission - creating a foundation for a creative workplace that leads to innovation, growth, and profitability. Through a wide variety of programs and initiatives, we invest in each employee, seeking to ensure that our people are not only respected as individuals, but also truly valued for their unique perspectives.

To learn more please visit:

- Reasonable accommodations will be determined on a case-by-case basis.

Functional Area:
CL - Claims

Estimated Travel Percentage (%): No Travel

Relocation Provided: No

AIG South Africa



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