Claims Controller

Industry: Insurance / Job Expires: 2023-04-30 07:21:22 / Location: Gauteng

Purpose

To collate records and examine information to assist in determining claim settlements, within the governed framework to ensure compliance with the short-term insurance regulations or to determine the validity of the claims from agent companies, assess the liability and negotiate settlements.

Minimum requirements

• Higher Certificate in Insurance NQF5.
• Relevant qualification.
• 3 – 5 years experience in a Claims position of Short term Insurance company.

Main duties

•  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.
• 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 analyse 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.

N.B: By responding to this advert, you consent to Heitha Staffing Group processing your personal information for recruitment purposes and confirm that any personal information has been submitted voluntarily. Applicants will be requested to fill in and sign a POPI Act Consent Form.

Only shortlisted candidates will be contacted. If you have not heard from us in 4 weeks, consider your application unsuccessful.

To apply please send your CV to intern2@heitha.co.za.