SOUTH AFRICAN SPECIAL RISK INSURANCE ASSOCIATION (SASRIA) VACANCIES

CLAIMS CONTROLLER
 
DETAILS
Closing Date 2024/03/01
Reference Number SAS240216-1
Job Title Claims Controller
Job Type Permanent
Division Insurance Operations
Department Claims
EE Occupational Levels Level 4 & 5: Skilled, Technical and Academically Qualified
Location - Town / City Sandton
Location – Province Gauteng
Location – Country South Africa
 
Job Advert Summary
The claims controller will 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
Minimum Qualifications:

• Higher Certificate in Insurance NQF5 (preferable)
• Tertiary education (preferable)

 
Minimum Experience:

• 3 – 5 years experience in a Claims position of Short term Insurance company

*Please note that preference will be given to people with disabilities.
 
Duties and Responsibilities   
1. 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.

 
2. 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.

 
3. Perform ad hoc tasks

• Perform any reasonable tasks as and when required by the Line Manager.

 
 
POLICY
We are committed to Employment Equity when recruiting internally and externally. It is company policy to promote from within wherever possible. Therefore, please be aware that internal candidates will be considered first before reviewing external applicants, provided that this supports achievement of our Employment Equity goals.
 
PLEASE APPLY HERE




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CLAIMS LEARNERSHIP X5 (12 MONTHS)
 
DETAILS
Closing Date 2024/02/22
Reference Number SAS240215-1
Job Title Claims Learnership X5 (12 Months)
Job Type Learnership
Division Insurance Operations
Department Claims
EE Occupational Levels Level 1: Unskilled
Location - Town / City Sandton
Location – Province Gauteng
Location – Country South Africa
 
Job Advert Summary
The learner should be able to process and handle claims within the delegated authority by ensuring validity, assessing liability and negotiating settlement, whilst ensuring excellent customer service and cost containment.
The management of claims should be within the governed framework to ensure compliance with the short term insurance regulations.
 
Minimum Requirements
 
Minimum Qualifications:

• National Senior Certificate/ Matric.

 
Minimum Experience:

• None

 
*Please note that preference will be given to people with disabilities*
 
Duties and Responsibilities   
1. Administration and Claims processing

• Perform administration functions – registration of new claims and loading (and authorization) payments.
• Examine and validate new claims and any related documentation thereof.
• Adjust claims and ensure that the merits are in line with Sasria policy cover.
• Ensure that the appropriate documents supporting the quantum are received and the calculations are correct.
• Perform document diary maintenance on IMS system.
• Update the reserve as per reserving policy and keep a regular follow-up outstanding proof of quantum.
• Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim within delegated authority.
• Approve claims within delegated authority after verification of all documents and validation thereof under the policy cover.
• Escalate complex and contentious claims to Supervisor.
• Manage and ensure that all other external resources and handle the claim within the required procedures and Sasria philosophy.
• Update notes on the system regularly to ensure notes reflect latest status of claim.
• Inform underwriting department of gaps in cover, omitted documents as well as losses/ gains on premium.
• Handle all customer enquiries and queries promptly and in-line with policy.

 
2. Agency/ Broker Liaison

• Negotiate the settlement of claims.
• Liaise with Agent companies and brokers regularly on the progress of the claim.
• Update all relevant stakeholders on the progress of the claim.
• 3. Perform ad hoc tasks
• Perform any reasonable tasks as and when required by the Line Manager.

 
 
POLICY
We are committed to Employment Equity when recruiting internally and externally. It is company policy to promote from within wherever possible. Therefore, please be aware that internal candidates will be considered first before reviewing external applicants, provided that this supports achievement of our Employment Equity goals.
 
PLEASE APPLY HERE