Claims Specialist - Ada

Bryte Insurance Company Limited; Johannesburg; On-site; ZAR 300,000 - 500,000; Full time

Job summary

A leading insurance company is seeking a Claims Specialist to manage claims processing and ensure accuracy in details. The role involves coordinating with internal and external stakeholders, handling large loss claims, and adhering to company policies. Ideal candidates will have a minimum degree and extensive experience in claims handling, particularly in property and business interruption claims.

Qualifications

• At least 5 years of claims handling or adjustment experience.
• Experience with large loss claims (>R1,000,000), especially property/business interruption claims.
• Strong knowledge of short-term insurance.

Responsibilities

• Process and maintain claims, ensuring accuracy and compliance.
• Coordinate with stakeholders for information verification.
• Manage and resolve ongoing queries effectively.

Skills

Claims handling

Negotiation

Customer service

Problem solving

Attention to detail

Education

Minimum Degree or NQF Level 4

Job description

Job Title: Claims Specialist - ADA

Location: Gauteng, Johannesburg

Deadline: June 22, 2025

Key Tasks & Accountabilities

1. Prioritize daily activities for processing and maintaining claims.
2. Verify accuracy of registered claims cover details and claimant information.
3. Confirm estimates are accurate, deducting excess, and investigate policy cover for claims.
4. Complete fraud checks and identify claims requiring further verification.
5. Forward computer-generated letters to relevant brokers.
6. Coordinate with stakeholders to gather and verify information.
7. Notify relevant departments (recoveries, salvages, verification units) as needed.
8. Record diary entries immediately after registration, noting claim progress and actions.
9. Manage and resolve ongoing queries.
10. Obtain necessary documents and assessor reports; amend estimates within policy limits.
11. Update and maintain diary system regularly.
12. Process payments accurately, ensuring correct banking details and documentation.
13. Send payment breakdowns to brokers.
14. Allocate correct codes to minimize leakage during claim payments.
15. Finalize payments within workflow and mandates.
16. Review open files quarterly for accuracy and completeness.
17. Log system issues promptly with relevant departments.

Customer Focus and Service

1. Coordinate with internal stakeholders to resolve problems efficiently.
2. Communicate claim progress and policies to stakeholders daily.
3. Resolve or escalate queries as appropriate, maintaining professionalism and service excellence.
4. Adhere to internal policies and procedures.

Adherence to Company Policies

1. Follow all company policies and standards.
2. Maintain professional dress code and behavior.
3. Manage attendance according to negotiated hours.

Relationships

Internal

• Claims Departments
• Sales
• Underwriting

External

• Brokers
• Clients
• Claims Suppliers
• Service Providers

Experience & Qualifications

• Minimum Degree or NQF Level 4
• At least 5 years of claims handling or adjustment experience.
• Experience with large loss claims (>R1,000,000), especially property/business interruption claims.
• Experience managing service providers and negotiating with stakeholders.
• Strong knowledge of short-term insurance.
• General claims handling skills.
• Understanding of Bryte’s principles, guidelines, and policies.
• Knowledge of claims technical guidelines and workflow systems.
• Understanding of company strategies, compliance, and organizational structure.