Job Title: FNOL Claims Consultant
Company Overview: Join
dedicated FNOL (First Notice of Loss) Claims Consultant to join their Claims Department.
Position
Overview: As an FNOL Claims Consultant, you will play a crucial role in our client's claims process by efficiently
assessing claims, and providing exceptional customer service to ensure a smooth and timely claims experience
investigations to assess the validity and coverage of claims.
Job Title: Marine Claims Specialist
Company Overview: Join
skilled and experienced Marine Claims Specialist to join their Claims Department.
Position
Overview: As a Marine Claims Specialist, you will play a crucial role in our client's Claims Department by
by managing marine insurance claims from initial reporting to resolution. You will work closely with policyholders
stakeholders to assess, investigate, and settle marine claims while ensuring compliance with company policies
IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation Compare the reorts to our exisitng claims criteria to establish if claim is payable Decide on levels of provisions Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals Experience in both group and life individual life claims is essential Sound Business and Operational knowledge
IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation Compare the reorts to our exisitng claims criteria to establish if claim is payable Decide on levels of provisions Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals Experience in both group and life individual life claims is essential Sound Business and Operational knowledge
monitor all claim related activities, which include the complete claim processing cycle of all claims, all claim claim related enquiries or complaints including Pension Fund Adjudicator and FSCA complaints / enquiries enquiries.
the role: Providing administrative support within Claims department. Key Responsibilities Confirming if policy. Registering a claim on the relevant system. Verifying the authenticity of claim documents received doctor. Assessing and validating claim documents received against the claims' standard operating requirements of the claim for approval and payment. Providing feedback on pending claims and repudiated claims. Monthly Monthly premium report and claims report. Qualifications: Matric (Grade 12) Diploma or Degree would be advantageous
variances. Revenue/Debtors Check all medical aid claims are loaded on Health Bridge and correctly submitted Medical Aid in respect of submitted claims and confirm status of claims. Follow-ups on payments due from Reconciliation of unmatched items on Health Bridge Claim reversal confirmations, approvals, and allocations allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid outstanding
variances. Revenue/Debtors Check all medical aid claims are loaded on Health Bridge and correctly submitted Medical Aid in respect of submitted claims and confirm status of claims. Follow-ups on payments due from Reconciliation of unmatched items on Health Bridge Claim reversal confirmations, approvals, and allocations allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid outstanding
the number of accidents and claims. Claims Risk Management Assist the claims administration team with developing strategies that can be used in managing claims risks. Assist the claims administration team with modelling modelling and establishing forecasts for claims volumes and settlements to monitor and improve operational efficiencies Reporting Extracting data and data reports from IT claim system(s). Ensure regular and periodic reports are