Commercial Claims Specialist
Insurance
Gauteng
A client in Sandton is seeking a dynamic and detail-oriented Commercial Claims Administrator to join their Short-Term Insurance team. The ideal candidate will play a crucial role in efficiently managing and processing claims for commercial insurance. This position requires a strong understanding of insurance policies, exceptional organizational skills, and the ability to provide exceptional customer service to clients throughout the claims process.
Responsibilities:
- Accurately assess and process insurance claims, adhering to company guidelines and industry regulations.
- Maintain comprehensive and organized records of all claims, correspondence, and related documents.
- Conduct thorough investigations to validate the authenticity and accuracy of claims, collaborating with relevant parties such as clients, adjusters, and external experts as needed.
- Analyze insurance policies to determine coverage, limitations, and exclusions, and communicate these findings to stakeholders.
- Effectively communicate with clients, brokers, and other stakeholders to provide updates on claim status, request additional information, and address inquiries promptly.
- Engage in negotiation with claimants, third parties, and service providers to ensure fair and efficient resolution of claims.
- Perform quality control checks on claim documentation to ensure accuracy and compliance with internal and regulatory standards.
- Generate and present regular reports on claims status, trends, and outcomes to management for analysis and decision-making.
- Deliver exceptional customer service throughout the claims process, demonstrating empathy and professionalism in interactions with clients during what can be challenging situations.
Requirements:
- Must have RE5 and FAIS credits
- Minimum of years of experience in claims administration within the insurance industry, with exposure to Commercial Lines.
- Must have Binder experience
- Solid understanding of short-term insurance principles, policies, and regulations.
- Keen attention to detail with the ability to analyze complex information accurately.
- Excellent written and verbal communication skills, with the ability to interact confidently and professionally with diverse stakeholders.
- Strong organizational and multitasking abilities to manage a high volume of claims efficiently.
- Effective problem-solving skills to navigate and resolve challenging claim scenarios.
- Proficient negotiation skills to reach fair settlements and manage disputes.
- Maintain the highest ethical standards when handling sensitive and confidential information.
- Ability to collaborate effectively within a team-oriented environment.
- Stay updated on industry regulations and compliance requirements to ensure claims processing aligns with legal standards.
Client offers a competitive salary with amazing benefits that include Medical Aid, Provident Fund, Assistance with Qualifications, Referral Incentives, etc.
Email: marizaan@proappoint.co.za
