Specialist: Claims Negotiator at Old Mutual South Africa

Job Description

• To provide a quality Specialist claims service, ensure containment of claims spend and provide excellent service in setting a culture of best practice within mandated responsibility.
• End-to-end claim processing including negotiation and settlement of Specialty Lines of Business claims
• Process Specialty lines claims in adherence with SLA.
• Arrange assessment in adherence with SLA.
• Review merit of claim.
• Complete Risk assessment and additional support request analysis.
• Clarify and amend information where required
• Appoint the support service required.
• Review Support Function Report.
• Calculate and Analyse technical computations.
• Capture all relevant claims updates and decisions on system.
• Manage Diarised actions aligned to SOP
• Prepare Rejection Letter, where required.
• Prepare Payment with communication details.
• Await additional information on multiple payments, if required.
• Continuously improve claims service, manage claims spend and contain the increase in average cost of claims.
• Improve / maintain Specialty Lines Claims service effectively.
• Reduce/ maintain turnaround time of Specialty Lines Claims.
• Ensure effective implementation and compliance of claims/ operational systems or procedures.
• Ensure diary is maintained.
• Ensure estimates are raised accurately and timeously in accordance with best practice as and when new claims and new documents are actioned.
• Adhere to Specialty Claims Standard Operations Procedures
• Maintain Turn Around Times

Experience Knowledge Skills Required:

• Matric
• Appropriate insurance qualification background
• Knowledge and interpretation of Specialty Lines policies
• 3 years Specialty Lines claims handling
• 5 years Commercial Non motor experience specifically Corporate Property, Engineering and Marine

Skills

• Action Planning, Claims Management, Claims Settlement, Data Compilation, Data Controls, Executing Plans, Financial Auditing, Insurance Claims Investigations, Oral Communications, Presenting Solutions

Competencies

• Business Insight
• Collaborates
• Decision Quality
• Drives Results
• Ensures Accountability
• Financial Acumen
• Instills Trust
• Manages Complexity

Education

• NQF Level 5 - Higher, Advance or Occupational Certificate or equivalent

Closing Date

• 29 July 2025