Claims Technician

2 weeks ago


Sandton, South Africa Neptune Full time

Hello… an exciting new opportunity has just become available in our Insure, Hollard Alternative Risk Transfer team. We are looking to recruit a Claims Technician.

 

Role Objectives

  • Manage and process all claims assigned, including legal requirements and industry regulations, predominantly Personal Lines claims, within the set standards require by the company thus contributing to the productivity of the division.
  • Manage rejections, cancellations, over claims mandates for Cell Captive/binder arrangements.
  • Enhance the image of the company through the continuous delivery of efficient and effective customer service.
Key Responsibilities:
  • Handle effective Claims processing
  • Adhere to legal requirements, industry regulations and customer quality standards set by the company
  • Authorize all claims above the binder’s set mandates
  • Ensure all claims within the designated portfolio are effectively and timeously processed within the stipulated turnaround times.
  • Get involved in loss adjusting activities and in legal discussions relating to settlement.
  • Management of claims reports from binder holders
  • Ensure adherence to Hollard Procurement procedures
  • Provision and adherence to claims service levels
  • Interpretation and application of policy terms and conditions ensuring all validation checks
  • Detection and management of fraud, dishonesty, misrepresentation
  • Handling rejections, ensuring fairness and diplomatic communication
  • Handling any complaints associated with claims.
  • Ensure application of business and scheme rules
  • Ensure the servicing principles of Hollard are always adhered to
  • Manage the correct, consistent interpretation and application of the policy wording and ensure that all claims are treated equitably
  • Day to day self-management of performance
  • Ensure appropriate controls are in place for valid claims settlement
  • Ad-hoc projects
  • Ensure accurate and timeous response to binder holders on queries
  • Monthly reports and communication to team leader/ management
  • Provide guidance to more junior staff on complicated or high-value claims
  • Dealing with third party and third-party recoveries
  • Claims reviews at binder holders
  • Binder Meetings / Reviews


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