Claims Consultant

1 week ago

Johannesburg, Gauteng, South Africa 62fc3cef-9a56-45e5-9cff-8d8291ad1dc9 Full time R250 000 - R500 000 per year

Job Description,
The purpose of an indemnity claims consultant is to facilitate a smooth and fair claims process for policyholders. They act as a bridge between the policyholder and the insurance/re-insurance company, ensuring that claims are handled efficiently and effectively. The primary responsibility is to assess the validity of claims, manage the claims process involving appointed legal counsel and expert witnesses, negotiate settlements, and ensure compliance with regulatory requirements.

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Requirements
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Duties and Responsibilities
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Key Accountabilities

  • Assist members with queries and formal incident reports.
  • Contribute to developing strategies for responding to reported incidents.
  • Set and review loss reserves for reported incidents.
  • Conduct trend analysis and environmental scans to anticipate market changes.
  • Manage relationships with appointed legal defense attorneys.
  • Participate in feedback loops to support continuous business improvement.
  • Draft simple written explanations for members facing scrutiny from professional registration bodies.
  • Prepare management reports related to claims activity.
  • Drive continuous improvement of claims management system functionalities.
  • Contribute beyond claims activity to broader organizational goals.
  • Oversee day-to-day administration of reported incidents.
  • Review claims to assess validity based on policy terms and conditions.
  • Communicate with policyholders, gather detailed claim information, and keep them informed.
  • Coordinate with professionals such as adjusters, investigators, and other experts on claim-related matters.

Knowledge And Skills

  • Strong analytical skills, including data analysis, market research, and financial analysis.
  • Excellent communication and interpersonal skills, with the ability to build strong relationships with clients and stakeholders
  • Knowledge of the industry, market trends, and competitor landscape.
  • Clear understanding of the insurance industry
  • Product and project management principles and execution frameworks
  • Proficiency across all Microsoft solutions
  • Strong analytical skills, including data analysis, market research, and financial analysis.

Competencies

  • Knowledge of all MS packages essential,
  • Advanced Excel skills beneficial,
  • Strict sense of confidentiality,
  • Business acumen,
  • Ability to multi-task maintaining attention to detail,
  • Ability to work under pressure and prioritise work,
  • Strong communication and interpersonal skills

Job Requirements

  • Willingness to travel for key stakeholder engagements,
  • Willingness to work overtime when required and be contactable after hours

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