Claims Manager, Johannesburg

Claims Manager:

The Claims Negotiator contributes to the organisational goals by processing (from registration through to settlement) and validating insured's (& Third parties') claims within reasonable time frames to meet the insured's needs and requirements. Results orientated and thrive within a high pressure dynamic environment. A strategic thinker who follows a decisive and proactive approach. A team player that is committed to acting with integrity, responsibility, and accountability.

The candidate must have a legal background with claims experience.

Salary negotiable for correct candidate depending on experience and knowledge.

Minimum Job Requirements;

• Admitted attorney
• LLB
• Commercial Insurance Industry claim knowledge
• Prepared to study towards a full FAIS qualification
• Must do Regulatory Representatives exam
• Minimum of 2 years' experience in claims
• Bilingual
• Efficient in word, excel and outlook
• Good communicator (verbal & written)
• Must be a problem solver (able to assimilate large amounts of information and apply policy wording)

Skills:

• Technical expertise
• Legal research on all pertinent matters
• Quality control
• Reporting
• Negotiation skills
• Risk Management
• Problem solving and generating solutions
• Decision making
• Customer service
• Innovative
• Understand applicable legislation
• Dedicated to maintaining high quality standards
• Responsible, self-motivated hard worker
• Excellent communication skills

Key Responsibilities:

• Operational
  • Sound knowledge of claims principles in industry including Claims management.
  • Actively manage and oversee start to end of claims function.
  • Contribute to the growth and profitability of the Company by providing excellent service and maintaining relationships.
  • Ensure complete and sound claim settlements, legal reviews and investigations in accordance with company policies and procedures.
  • Do legal research to ensure compliance.
  • Manage and organize day to day operations by establishing priorities to ensure registering, handling and settling of claims on Company's delegated authority and at the same time maintain the standards of the claims department.
    • Controlling of registers, compliance with SLA's, diary management, quantum, recoveries, salvage and secure proper claims maintenance.
    • Assessment of claims.
    • Ensure all technical aspects for claims settlement are adhered to.
    • Negotiate settlement of the claims with all relevant stakeholders
    • Daily diary files to be extracted and dealt with e.g. letters of demand, final notices reminders and follow up assessors' reports
  • Registering claims with the reinsurers/co insurers
  • Facultative reinsurance & co-insurance recoveries.
  • Monitor and periodically review estimates.
  • Appointment of investigators, assessors, loss adjusters and other experts if necessary
    • Negotiate discounts to reduce costs with repairers, service providers and partners, without compromising quality or harming client retention initiatives
  • Attend to Third party claims in terms of the Plant and Contractors Third Party Liability cover
    • Signing off of third party releases.
    • Third Party recoveries.

• Relationship Management
  • Liaising in a professional manner with brokers and other insurers in respect of claims aspects
    • Following up on regular intervals and provide constructive feedback to brokers and management
    • respond to queries within 24 hours
  • Liaising with attorneys, giving instruction to attorneys to act on Insurers behalf.
  • Work with different people internally and externally to improve service, efficiency, and improve presentation of information.
  • Procure service providers and partners, negotiate costs.
  • Actively build, improve and maintain relationships with all stakeholders, i.e. internally and externally. Meet with brokers, service providers, partners and other divisions to ensure challenges they may face are addressed.