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Senior Claims Technician

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2 years ago1765 views

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General Details

Location:

Johannesburg CBD, Johannesburg

Advertised By:Agency

Company Name:CFS Recruitment

Job Type:Full-Time

Description

You must have at least 7 years of Short Term Insurance Claims & Underwriting Experience in Commercial Lines

Matriculation certificate
RE5
NQF 4
CPD Points up to date
Insurance qualification (preferred) – 120 credits higher certificate or equivalent
Team Player
Self-driven and able to start working independently in the near future with the company policy framework

Duties:

Understand a client’s needs from the scenario given
Understand when more information is required in order to process the claim
Address all claims within the agreed turnaround times as per the procedure manual/service agreements
Work with the Broker/Account Executive to understand progress on the claim and any issues/delays
Ensure that audit requirements as per insurer binders and/or intermediary arrangements are met before approving the claim payment
Meet with the Broker/Account Executive on a regular basis to discuss claims on the portfolio
Register the claim on the system and ensure all documents are saved correctly
Ensure documents are always in order and system/estimates input is updated and correct
Advise underwriters when there are amendments to be made on a policy
Ensure compliance to all processes, policies and procedures and identify areas for improvement
Take responsibility for managing own time and delivery

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Id Subtitle 1063582623

CFS Recruitment

Selling for 2+ years

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Identify fraud trends and continuously develop process improvements and mitigation controls to support the Group Business. Proactively engage with key stakeholders both internally and externally to gather intelligence and create and develop relationships with key organisations. Responsibilities of the Role: Successfully lead a team of Investigation Officers by providing quality regulatory technical expertise, case direction and excellent operational management to ensure assurance procedures, file and document reviews etc.Maintains an overview of all cases within the team to provide expert technical guidance and case direction and ensure the work is always of high quality and that there is a consistent, timely approach taken with each case.Responsible and accountable for high-quality and timely case progression within the team.Provides regular case updates/reviews to senior managers and key stakeholders, especially in relation to high profile and sensitive matters.Positively and proactively contributes as part of the Investigation leadership team in implementing changes and improvements as appropriate.Ensure that reports and documentation are produced to the highest standards, which will stand up to the scrutiny of the Section 91 Tribunal and Courts - supporting and coaching Investigation Officers as required.Effectively manage and motivates the team/individuals by providing clear communication, robustly managing performance/providing timely constructive feedback (regular reviews) and supporting/coaching individuals to improve and fully engage in their own development and learning.Work collaboratively across the organization and demonstrate a positive and proactive approach to achieving organisational objectives, including providing expertise and taking responsibility for leading on projects and priorities.Investigations are outcomes-focussed, timely and a risk-based approach is developed and executed for each investigationInterpret policy and decisions to stakeholders for effective communicationRepresent the company at various forums and interact with other stakeholdersIdentify and report falsified claims to the Legal Operations for recovery purposesIdentify fraud trends by analysing data and industry alertsIdentify suspicious activity and work with appropriate teams to investigate and thwart the activityProvide statistical data on losses on a regular basisDevelop processes and procedures to prevent or minimise claims fraud lossesEnsure Service Level Agreement and turnaround times of external serviceproviders and internal investigators are adhered to Identify key risk indicators and establish mitigating controlsEnsure that expenditure is incurred within the limits of the sanctioned budgetEnsure that new r... https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8yOTYyMDc0MzMxP3NvdXJjZT1ndW10cmVl&jid=1422200&xid=2962074331

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Commercial Underwriter Extraordinaire - Ignite Your Underwriting Genius! Are you ready to take your underwriting prowess to new heights? Were on the lookout for a Commercial Underwriter with a passion for turning risks into opportunities in the dynamic world of insurance. About Our Client: Our client is not your average insurance firm. Theyre a trailblazer in the industry, known for their innovative approach and commitment to excellence. Join our client as a Commercial Underwriter and be part of a team that thrives on challenge and diversity. Key Responsibilities: Risk Maestro: Evaluate commercial insurance applications with a discerning eye, determining acceptable levels of risk and crafting tailored coverage solutions. Collaborative Orchestrator: Work closely with brokers, clients, and internal teams to gather information, analyze data, and ensure seamless underwriting processes. Innovation Connoisseur: Stay ahead of industry trends and contribute to the development of new underwriting strategies and products. Customer Whisperer: Provide expert advice to clients and brokers, building strong relationships based on trust and expertise. Needs to have knowledge and understanding of various Commercial products – in depthknowledge.Needs to understand Commercial Lines product requirements.Needs to understand and have knowledge of how the Commercial Lines Industry works. The trendseg. Auto Rating etc.Be able to translate product requirements into system functionality – Eg. What information isrequired to be captured and how should it be validated. Minimums, Maximums, Accumulations,Computations (for when item Sums Insured must be computed from another item within arisk/section), etc. Qualifications: Matric is an essential requirement.Regulatory Exam: Representatives.FAIS Credits (as per FAIS requirement).Must be Fit & Proper in terms of the FAIS Act.Must not be debarred with FSB Experience in the financial services industry or short-term insuranceindustry (preferable)Proven experience as a Commercial Underwriter in the insurance industry.In-depth knowledge of commercial insurance policies, regulations, and market trends.Strong analytical and decision-making skills.Excellent communication and negotiation abilities. Perks and Benefits: Competitive salary and performance-based bonuses.Comprehensive health and wellness benefits.Opportunities for professional development and growth.A vibrant and collaborative work environment. https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8yNjA0MTI3Nzg0P3NvdXJjZT1ndW10cmVl&jid=1749265&xid=2604127784

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Role Purpose Implement the compliance strategy aligned to the compliance monitoring plan to assist the business in honoring their responsibility to comply with applicable regulatory requirements through directing the compliance function through identification, assessing, managing, monitoring and report on regulatory compliance risks facing the organisation. The position shall further provide assurance that company policies and procedures are being complied with and that the organisation meets the regulatory and companys own standards and ensure that compliance support is aligned to business strategy. Responsibilities and work outputs Implement and manage an effective compliance program through the development and management of risk and compliance plans.Develop and review company policies including effective implementation of policies and guidelinesAdvise management on the company’s compliance with laws and regulations through detailed reports.Create and manage effective action plans in response to audit discoveries and compliance violations.Regularly audit company procedures, practices, and documents to identify possible weaknesses or risks.Tracking and monitoring of key risk indicators, controls and action plans.Assess company operations to determine compliance risk.Conduct research on compliance related topicsDevelop training materials and assist with training to ensure all employees are educated on the latest regulations and processes.Assist in compiling risk and compliance reportsCollaborate with other leaders on cross-functional initiatives that focus on the mitigation of compliance risks.Work with external partners such as Internal Audit to endure the effectiveness of the compliance functionAssist in innovate the Compliance program and function and identify improvements to existing processes and plans.Provide guidance to business and assist with implementation of compliance policies and projects.Drafting and compiling regulatory submissions. Competencies Excellent organisational and administrative skillsExcellent communication skills (verbal and written)Report writing skillsAccountable, takes Ownership and ResponsibilityAttention to detailNegotiation skills and Problem-solving abilityStrong People skillsAbility to work independently and in a team environmentAnalytical thinker with investigative instinctSelf-disciplined and self-motivatedStress Tolerance, tenacity and ResilienceProfessional approachAssertive and tactful with the ability to handle conflictResults driven https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8xMzUwNjA1NzY5P3NvdXJjZT1ndW10cmVl&jid=1512319&xid=1350605769

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