Claims Analyst

Reference : JHB -DDT -1

Are you a meticulous individual with a knack for managing commercial claims efficiently? Our globally recognised client in Randpark Ridge is looking for a skilled Claims Analyst to spearhead interactions with clients, brokers, and insurers, ensuring seamless processing and resolution of claims. Please apply if you have at least 3 years' experience with the full life cycle of claims.

Duties & Responsibilities

• Handle claims as per delegated claims portfolio from cradle to grave.
• Daily Administration – Registering of new claims and ensuring that cover is in place and the correct excess is applied.
• On-going daily administration – all documents are timeously and accurately saved to the correct claim or policy file, as well as updating main statuses and additional statuses throughout the life cycle of the claim.
• Estimates are to be added correctly and updated throughout the claim life cycle, referring to the “maximum probable loss” theory.
• Liaising with the claims manager to establish your claims allocation and priority claims to be attended to.
• Maintain and manage the outstanding claims list to acceptable levels and with the focus on finalising claims faster and with the necessary broker satisfaction.
• Handling of broker telephone and email queries to limit broker complaints.
• Manage all relevant and expected communication to internal stakeholders within the agreed Service Level Agreement (SLA) or treaty requirements.
• Ensure that claims are finalized within agreed SLA period.
• Determine merit, investigation and determine whether external service providers are required.
• Assess claims by reviewing field reports, assessments and / or digital images or document received.
• Proactive identification of fraudulent cases and recovery potential and acting upon the identification in a pro-active manner.
• Proactive identification of salvage potential and acting upon the identification in a pro-active manner.
• Understands legal liability considerations in given claims.
• Decide on settlement recommendation or refer to the Claims Manager.
• Liaise with internal stakeholders, e.g. Underwriting, Assessing and Legal for Policy interpretation issues.
• Pro-actively manage broker expectation and ensure that all communication to brokers are completed timeously and accurately.
• You are responsible for all claims reporting to holding company and managed within the required treaty specifications.
• Ensure that payments are raised correctly and accurately to the correct beneficiary.
• All new beneficiaries receive the Beneficiary Form for completion.
• Completed beneficiary forms and BEE Certificates are correctly saved within the Compliance folder.
• Self-manage and complete allocated / received emails and diaries on a daily basis.
• If the claim falls within your portfolio, ensure that any and all correspondence is saved to the file timeously and accurately. This includes emails that may have been sent by another member of staff.
• Daily statistics are sent to the line manager at the end of each day.

Minimum Requirements

Package & Remuneration

R 25 000 - R 30 000 - Monthly

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