Claims Controller - Sandton at Sasria

Minimum Qualifications:

• Higher Certificate in Insurance NQF5 (preferable)
• Tertiary education (preferable)

Minimum Experience:

3 – 5 years experience in a Claims position of Short term Insurance company

Duties and Responsibilities

1. Claims processes

• Accurately record and examine received claims and any related documentation thereof.
• Perform document diary maintenance on CMS system.
• Assess claims received by the department for reserve and keep a regular follow-up outstanding reserve once claims are verified by Claims Manager.
• Approve claims within delegated authority after verification of all documents and validation thereof under the policy cover.
• Escalate complex claims to Supervisor.
• Assist in the extrapolation of monthly reports on claims.

2. Agency/ Broker Liaison

• Inform underwriting department of gaps in cover and/or wording documents as well as adjustors such as losses/ gains on premium.
• Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
• Negotiate the settlement and disposition of claims within prescribed mandate; interpret related claims documentation.

3. Perform ad hoc tasks

• Perform any reasonable tasks as and when required by the Line Manager.