Claims Consultant (Klerksdorp) at Senwes

Description

• We’re looking for a dedicated professional to join our team in the role of Claims Consultant. The individual plays a key role in the effective handling, mediation, and verification of registered claims, ensuring accuracy and efficiency throughout the claims process.

Verification of Registered Claims

• Generate and maintain the Registered Claims Report.
• Perform comprehensive verification of all registered claims, including:
• Accurate department allocation
• Validation of premium payments
• Verification of peril codes
• Assessment of transaction estimates
• Review of supporting documentation
• Confirmation of timely claim submission.

Management of Problematic Claims

• Receive and evaluate queries from brokers.
• Identify and analyze the root cause of claim issues.
• Gather and document all relevant information.
• Refer matters to appropriate internal stakeholders.
• Prepare and maintain detailed progress reports.
• Escalate complex or unresolved issues to the Claims Manager as needed.

Claims Administration

• Receive and log registered claims submitted by brokers.
• Verify the authenticity and completeness of each claim.
• Update internal systems with accurate claim data.
• Oversee the end-to-end administration of claims, including:
• Appointing assessors and evaluating their reports
• Requesting and reviewing quotations
• Authorizing repairs, replacements, or cash settlements within mandate
• Managing salvage processes
• Referring specific claims to insurers as per mandate
• Submitting invoices or agreements of loss for payment authorization
• Capturing all relevant claim information in the system
• Referring recoveries and third-party claims to appropriate stakeholders
• Ensuring timely follow-up on all claim-related activities
• Maintaining organized records and documentation
• Responding to inquiries and resolving queries.

Communication and Reporting

• Communicate claim outcomes to brokers promptly.
• Coordinate and manage procurement processes related to claims.
• Compile and submit monthly management reports.
• Provide technical advice and support to brokers.
• Ensure adherence to all relevant Service Level Agreements (SLAs).
• Monitor claim trends per insured party and escalate to underwriting when necessary.

Requirements

• Microsoft office (Excel & Word)
• At least 5 years experience in a Short Term Insurance, Claims handling and Mediation

Qualifications:

• National Senior Certificate
   

Closing date: 13 January 2026