Claims Disputes Specialist – Independent Review Expert

Old Mutual South Africa; Johannesburg; On-site; ZAR 500 000 - 700 000; Full time

Job summary

A leading insurance firm is seeking a professional to manage claims disputes in Johannesburg. The ideal candidate will have an LLB degree, 5-8 years of complaints management experience in the General Insurance Industry, and ability to resolve escalated customer queries effectively. This role will also investigate and analyze complex claims while ensuring compliance with policies and legislation. The position offers opportunities for professional development and is aligned with the company's commitment to customer satisfaction.

Benefits

Professional development opportunities

Competitive salary and benefits

Qualifications

• 5 – 8 years’ experience in a complaints management function in the General Insurance Industry.
• 2 – 3 years’ experience working with the Ombudsman.
• Strong knowledge of insurance policies and regulatory frameworks.

Responsibilities

• Investigate claims thoroughly and ensure fair resolutions.
• Conduct root cause analysis for disputes and recommend preventive measures.
• Maintain effective communication with stakeholders and internal arbitrators.

Skills

Action Planning

Claims Management

Data Compilation

Data Controls

Executing Plans

Financial Auditing

Insurance Claims Investigations

Oral Communications

Policies & Procedures

Typology

Education

LLB or equivalent degree

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

Job description

A leading insurance firm is seeking a professional to manage claims disputes in Johannesburg. The ideal candidate will have an LLB degree, 5-8 years of complaints management experience in the General Insurance Industry, and ability to resolve escalated customer queries effectively. This role will also investigate and analyze complex claims while ensuring compliance with policies and legislation. The position offers opportunities for professional development and is aligned with the company's commitment to customer satisfaction.