Claims Consultant

Pro Talent; Gqeberha; Presencial; ZAR 320 000 - 520 000; Tempo integral

Resumo da oferta

Pro Talent in South Africa is seeking a qualified short-term claims professional to manage end-to-end insurance claims. You will register claims, track progress, and ensure compliance with procedures and insurer requirements.

You will liaise with clients, service providers, assessors, attorneys and insurers to resolve claims efficiently while maintaining accurate diaries, file notes and timely payment verifications.

Qualificações

• NQF4 in short term insurance required.
• Minimum 3-5 years' experience in short term claims.
• Knowledge of insurance claims processes.
• FAIS compliant and RE5 qualification.
• Strong computer literacy.

Responsabilidades

• Register and manage insurance claims from inception through to settlement.
• Ensure claims exceeding settlement authority are referred to insurers within 1 working day of claim registration or immediately once quantum has been confirmed.
• Investigate and process claims in accordance with company procedures and insurer requirements.
• Maintain an accurate and up-to-date claims diary on Flexi/Nimbis on a daily basis.
• Record and maintain comprehensive file notes on Flexi/Nimbis regarding all claim-related interactions.
• Save and upload all claim correspondence and communications onto Flexi/Nimbis within 1 working day of receipt.
• Monitor claims analysis reports and ensure outstanding balances are accurately managed.
• Ensure open claims do not reflect incorrect or nil balances where outstanding amounts remain.
• Ensure all settled claims reflect a nil outstanding balance.
• Verify claim payments before processing to ensure accuracy and completeness.
• Liaise with clients, service providers, assessors, attorneys, and insurers to facilitate efficient claim resolution.
• Maintain service standards and turnaround times while ensuring compliance with internal controls and regulatory requirements.

Conhecimentos

Analytical skills

Problem-solving

Attention to detail

Regulatory knowledge

Communication skills

Formação académica

NQF4 in short term insurance

FAIS compliant

RE5 qualification

Ferramentas

Computer knowledge

Descrição da oferta de emprego

MINIMUM REQUIREMENTS

• NQF4 in short term insurance.


• Minimum 3 - 5 years' experience in short term claims environment


• Knowledge of insurance claims processes and procedures


• FAIS compliant and RE5 qualification


• Strong computer knowledge

KNOWLEDGE AND SKILLS

• Excellent analytical and problem-solving skills


• Insurance regulatory knowledge


• Excellent attention to detail


• Ability to work independently and as part of a team


• Ability to work under pressure and meet deadlines


• Excellent analytical, communication, and presentation abilities.


• High level of integrity and accountability

RESPONSIBILITIES

• Register and manage insurance claims from inception through to settlement.


• Ensure claims exceeding settlement authority are referred to insurers within 1 working day of claim registration or immediately once quantum has been confirmed.


• Investigate and process claims in accordance with company procedures and insurer requirements.


• Maintain an accurate and up-to-date claims diary on a daily basis.


• Record and maintain comprehensive file notes on Flexi/Nimbis regarding all claim-related interactions.


• Save and upload all claim correspondence and communications onto Flexi/Nimbis within 1 working day of receipt.


• Monitor claims analysis reports and ensure outstanding balances are accurately managed.


• Ensure open claims do not reflect incorrect or nil balances where outstanding amounts remain.


• Ensure all settled claims reflect a nil outstanding balance.


• Verify claim payments before processing to ensure accuracy and completeness.


• Liaise with clients, service providers, assessors, attorneys, and insurers to facilitate efficient claim resolution.


• Maintain service standards and turnaround times while ensuring compliance with internal controls and regulatory requirements.