What will you do?
Claims Portfolio
Attend to all aspects related to a portfolio of claims e.g. new claims, current files, diary, mail, recoveries, Agg Tracker management, third party claims, attorney/investigator matters, settlement within mandate etc.
Negotiate settlement agreements within mandate
Draft settlement agreements
Strategically manage a portfolio of claims
Appoint and manage loss adjusters and attorneys where warranted
Monitor and adhere to service levels in accordance with agreed service level agreements
Monitor legal loss adjuster fee expenditure and refer concerns to management within the framework of agreed internal protocol
Analysis
Analyse factual and legal issues when assessing claims
Critically analyse facts and their impact on the underlying merits assessment as well as the legal aspects of the policy
Use judgement in making appropriate decisions on merits and policy response
Critically assess and analyse the information required
Conduct a strategic assessment of claims and make strategic decisions on handling of claims
Have an in-depth understanding of technical and legal aspects impacting on the policy's operation
System Processing
Attend to all aspects of system processing relevant to a portfolio of claims e.g. registration of new claims, updating of reserves, cheque requisitions etc.
Client Liaison (Internal and External)
Respond to queries and resolve to the satisfaction of the affected parties within the scope of authority and/or responsibility
Maintain and adhere to service levels
Prepare for and attend meetings
General Administration
Produce reports when required
Attend to daily administrative routine tasks in accordance with organisational standards, processes and procedures
Attend to the typing of general correspondence if and when necessary
Qualification and Experience
Qualifications
Matric
FAIS compliance (within the required period if not a registered Rep)
Medical Qualification (if possible)
Experience
Minimum 6 months A&H claims handling experience a preference
Analysis of medical accounts and medical claims handling a preference
Assessing medical reports and understanding medical terminology
Knowledge and Skills
Generic
Administrative Skills
Analysis and Judgement
Attention to Detail
Client Orientation
Communication Skills including negotiation
Follow Up
Initiative
Interpersonal Skills
Organisational Awareness
Planning and Organising
Teamwork
Computer Literacy
Time management and ability to manage multiple claims at the same time
Specific
Ability to strategise and drive a claim to finality
Our Commitment to Transformation
Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia.
Our success is rooted in our passion for our clients and everything we do is centered on our delivery of Insurance Good and Proper. We're about people. People drive our business so it follows that we want to recruit the best people possible whether they work for us permanently or for a short time as temporary employees.
At Santam we are committed to transformation and embracing diversity. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society. In achieving our employment equity goals we give preference to applicants from the designated groups in alignment with the Divisions Employment Equity targets.
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