Damage Moderator

PPS Recruitment; Johannesburg; On-site; ZAR 900,000 - 1,300,000; Full time

Job summary

PPS Recruitment in Johannesburg is seeking an experienced Short-Term Insurance claims moderator to assess, moderate, and investigate motor and non-motor claims. The role involves auditing claims, determining liability, and negotiating settlements with claimants.

The ideal candidate has 10 years in STI claims, with at least 5 years in loss adjusting or investigation, strong analytical and communication skills, and the ability to travel occasionally with their own vehicle.

Qualifications

• 10 years in Short-Term Insurance claims environment.
• 5+ years loss adjusting/investigating STI claims (Personal & Commercial).
• Strong knowledge of property insurance, claims verification, and regulation.

Responsibilities

• Multi-skilled Claims Moderator (STI Motor and Non-Motor).
• Overseeing claims Investigation.
• Assessment and Analysis.
• Negotiation and Settlement.
• Documentation and Reporting.
• Customer Service.
• Continuous Improvement and process implementation.

Skills

Customer Service

Claims processes

Negotiation

Auto Body

Claims software

MS Office

Education

NQF Level 4

Grade 12

VDQ

ACFE

Tools

Codeplex

Job description

The incumbent will be responsible for assessing, moderating, and investigating various types of Short-Term Insurance claims (motor and non-motor). This role includes auditing claims, determining the extent of the insurance company's liability, and negotiating settlements with claimants as necessary.

The ideal candidate will have extensive experience in handling Short-Term Insurance claims, strong analytical skills, and excellent interpersonal abilities to manage and resolve claims effectively. The successful candidate must also be prepared to travel occasionally, sometimes on short notice, using their own reliable vehicle.

Education:

• NQF level 4 : Grade 12
• VDQ will be an advantage
• ACFE will be an advantage

Experience:

• 10 years’ experience within a Short-Term Insurance claims environment (both for Commercial and Personal Lines).
• Minimum 5 years Loss Adjusting / Investigating of Short-Term Insurance Claims both Personal Lines and Commercial
• Advanced knowledge of property insurance, claims verification, coverage evaluation, loss assessment (both physical damage and financial loss), reserving, insurance legal & regulatory environment, claims processes, applications/systems and procedures, and finance.
• Codeplex experience would be an advantage.

Knowledge and Skills:

• Customer Service Skills
• Thorough understanding of claims handling process
• Knowledge of Commercial and Personal Lines claims processes and the validation thereof.
• Negotiation Skills
• Knowledge of the Auto Body repair industry.
• Proficiency in claims management software and Microsoft Office Suite.

Duties and Responsibilities

Key Responsibilities:

• Multi-skilled Claims Moderator (STI Motor and Non-Motor)
• Overseeing claims Investigation
• Assessment and Analysis
• Negotiation and Settlement
• Documentation and Reporting
• Customer Service
• Continuous Improvement and process implementation

Risk and Compliance

• Adhere to internal SLA's to ensure operational efficiency and achievement of agreed customer service standards
• Identify trends in claims and train consequences thereof into the claims team.
• Ensure adherence to audit requirements.
• Ensure adherence to regulatory and compliance requirements.

People and Culture

• Create a motivated work environment where employees want to work hard to achieve service excellence by providing regular feedback on their performance and by making sure that the employees' efforts are recognized.
• Determine and analyse training needs for the claims team and ensure that all agreed development/training interventions are scheduled, approved and executed.
• Ensure continuous improvement and updating of work instructions and process documents.
• Provide input in development and updating guidelines to support the assessment/investigation of claims.