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Specialist : Claims Consultant

Specialist : Claims Consultant

Old MutualZA
1 day ago
Job description

Job title : Specialist : Claims Consultant

Job Location : Gauteng,

Deadline : December 30, 2025

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Job Description

  • To provide a quality Specialist claims service, ensure containment of claims spend and provide excellent service in setting a culture of best practice within mandated responsibility.

    • Critical objectives and responsibilities

  • Strategic thinking
  • Customer centricity
  • Collaboration
  • Leading with Influence
  • Innovation
  • Personal Mastery
  • Executing
  • End-to-end claim processing including negotiation and settlement of Specialty Lines of Business  claims
  • Process Specialty lines claims in adherence with SLA.
  • Arrange assessment in adherence with SLA.
  • Review merit of claim.
  • Complete Risk assessment and additional support request analysis.
  • Clarify and amend information where required
  • Appoint the support service required.
  • Review Support Function Report.
  • Calculate and Analyse technical computations.
  • Capture all relevant claims updates and decisions on system.
  • Manage Diaries actions aligned to SOP
  • Prepare Rejection Letter, where required.
  • Prepare Payment with communication details.
  • Await additional information on multiple payments, if required.
  • Continuously improve claims service, manage claims spend and contain the increase in average cost of claims.
  • Improve / maintain Specialty Lines  Claims service effectively.
  • Reduce / maintain turnaround time of Specialty Lines Claims.
  • Ensure effective implementation and compliance of claims / operational systems or procedures.
  • Ensure diary is maintained.
  • Ensure estimates are raised accurately and timeously in accordance with best practice as and when new claims and new documents are actioned.
  • Adhere to Specialty Claims Standard Operations Procedures
  • Maintain Turn Around Times

    • Experience, knowledge & skills required

  • Matric
  • Appropriate insurance qualification background
  • Knowledge and interpretation of Specialty Lines  policies
  • 3 years Specialty Lines  claims handling
  • 5 years Commercial Non motor experience specifically Corporate Property, Engineering and Marine

    • Skills

  • Action Planning, Claims Management, Claims Settlement, Data Compilation, Data Controls, Executing Plans, Financial Auditing, Insurance Claims Investigations, Oral Communications, Presenting Solutions

    • Competencies

  • Business Insight
  • Collaborates
  • Decision Quality
  • Drives Results
  • Financial Acumen
  • Instills Trust
  • Manages Complexity
  • Optimizes Work Processes

    • Education

  • NQF Level 7 - Degree, Advance Diploma or Postgraduate Certificate or equivalent

    • Closing Date

  • 16 November 2025
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    Consultant • ZA

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