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Job Summary
JOB PURPOSEThe main purpose of the Claims Specialist’s role is to validate and administrate a client’s motor claim following a fortuitous event. In accordance with Standard Operating Procedure, claims guidelines, the specialist own mandate, and the client’s policy schedule, the specialist will make a claims settlement determination.
Service delivery is our main distinguisher from our competitors and individual performance is mainly measured on the quality and turn-around times of service offering.
REQUIREMENTS
ACADEMIC (DEGREE OR DIP)
✓ Matric (Grade 12) - essential
✓ FETC (Further Education & Training Certificate) in Short Term Insurance – NQF 4 (150 credits)
✓ Higher Certificate in Short Term Insurance – NQF 5 or higher – highly advantageous
✓ Successfully passed RE 1 (Representative Exam)
✓ Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous
✓ Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised.
MINIMUM OTHER TRAINING REQUIRED
✓ Computer literate – Microsoft Word, Excel, and Outlook
✓ Experience working on the TIAL Operating System (System A) – highly advantageous
✓ Experience in HCV (heavy commercial vehicles), Fleets and AGRI claims – highly advantageous
MINIMUM YEARS OF FORMAL & INFORMAL TRAINING REQUIRED
✓ At least 5 years relevant work experience in Personal, Commercial and AGRI claims settlement
✓ Work experience within a licensed insurer – highly advantageous
✓ Experienced in making claims settlement determinations with mandate exceeding R50 000
✓ Effective time management skills required
COMPETENCIES REQUIRED
✓ Effective Communication and interpersonal skills
✓ Ability to collaborate and network with multiple parties inside and outside the company
✓ Must have confidence to make decisions with limited need for referral
✓ Must have effective conflict management skills and the ability to handle ‘tough’ conversations
✓ Assertiveness
✓ Solutions oriented
✓ Drive and persistence
✓ Energetic with a positive outlook
✓ Must be focused, self-disciplined, and deadline driven
✓ Must project tenacity, professionalism and confidence
✓ Must genuinely enjoy interacting with people – service oriented
✓ Must be resilient and agile
✓ Ability to function independently and under pressure
✓ High attention to detail
✓ Proactive/ ability to use own Initiative
Key Performance Areas
✓ Validation of claims in line with Company guidelines and Standard Operating Procedures
✓ Appointment of necessary providers
✓ Authorizations\Settlement of claims
✓ Rejection of claims
✓ Processing payments within the turn-around time
✓ Payment confirmations to Brokers and Suppliers
✓ Assisting clients and brokers over the phone / email with claims and queries
✓ Complaints handling and resolution
✓ Liaising with Service Providers
✓ Liaising with brokers and clients
Key clients
Brokers, internal staff and managers, service providers & policy holders
***Please note only shortlisted candidates will be contacted***
Manpower Group
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