Categories: Career

Claims Controller

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Closing Date	2023/05/03
Reference Number	SAS230418-1
Job Title	Claims Controller
Job Type	Permanent
Division	Insurance Operations
Department	Claims
EE Occupational Levels	Level 2 & 3: Semi-skilled
Location – Town / City	Johannesburg
Location – Province	Gauteng
Location – Country	South Africa
Job Advert Summary	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	Qualifications:• Higher Certificate in Insurance NQF5 (preferable) • Tertiary education (preferable)Experience:• 3 – 5 years experience in a Claims position of Short term Insurance company
Duties and Responsibilities	Claims Processes:• 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.Agency/ broker Liaison• 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 analyze 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.Perform ad hoc tasks• Perform any reasonable tasks as and when required by the Line Manager.