Claims Manager - Tygervalley, South Africa - PSG Insure

PSG Insure

Verified Company

Tygervalley, South Africa

2 weeks ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Job Description:

As a Short-term Insurance Claims Manager, your primary responsibility will be to oversee and manage the claims process for various types of short-term insurance policies.

You will be responsible for ensuring efficient and accurate claims handling while maintaining a high level of customer satisfaction.

This role requires excellent organizational and analytical skills, as well as the ability to effectively manage a team of claims adjusters.

Responsibilities:

Claims Management: Oversee the entire claims process, from initial notification to final settlement, ensuring that all claims are handled in accordance with company policies and industry regulations.
Team Management: Lead and manage a team of claims adjusters, providing guidance, training, and performance feedback to ensure the team's productivity and quality standards are met.
Claims Evaluation: Review and assess claim submissions, including supporting documentation, to determine coverage eligibility and validate the extent of loss or damage.
Investigation: Conduct investigations when necessary to gather additional information or evidence related to claims, such as accident reports, medical records, or witness statements.
Documentation and Reporting: Ensure accurate and complete documentation of all claimsrelated activities, maintaining proper records and producing regular reports for management review.
Customer Service: Handle complex or escalated customer inquiries or complaints related to claims, providing timely and professional assistance to address concerns and resolve issues.
Fraud Detection: Collaborate with the fraud investigation team to identify and mitigate potential fraudulent claims, implementing appropriate preventive measures and reporting suspicious activities.
Vendor Management: Liaise with external service providers, such as loss adjusters, lawyers, and medical professionals, to ensure prompt and efficient processing of claims.
Compliance: Stay up to date with industry regulations and legal requirements related to insurance claims, ensuring adherence to all relevant guidelines and standards.
Process Improvement: Continuously evaluate and identify opportunities to enhance the claims process, suggesting and implementing improvements to increase efficiency and customer satisfaction.

Qualifications:

Bachelor's degree in Insurance, Business Administration, or a related field (or equivalent work experience).
Extensive experience in shortterm insurance claims management, with a proven track record of successfully handling complex claims.
Strong knowledge of insurance policies, coverage, and claims procedures.
Excellent leadership and team management skills, with the ability to motivate and develop a highperforming team.
Exceptional analytical and problemsolving abilities, with attention to detail and accuracy.
Effective communication and interpersonal skills, with the ability to interact professionally with customers, colleagues, and external stakeholders.
Proficiency in using claims management software and other relevant tools.
Familiarity with fraud detection and prevention strategies in insurance claims.
Sound knowledge of insurance industry regulations and compliance requirements.
Ability to work under pressure, manage multiple priorities, and meet deadlines.

This role is advertised for Western National Insurance a Division of PSG Insure. If you believe you have what it t

Salary:
From R1.00 per month