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Job Description
naTo 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 SolutionsCompetencies
Business InsightCollaboratesDecision QualityDrives ResultsEnsures AccountabilityFinancial AcumenInstills TrustManages ComplexityEducation
NQF Level 5 - Higher, Advance or Occupational Certificate or equivalentClosing Date
29 July 2025 , 23:59The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.
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