Description

Job Summary

We are seeking an experienced Claims Negotiation Specialist to join our team at Old Mutual. As a key member of our claims function, you will play a critical role in delivering high-quality claims negotiation outcomes through effective and efficient claims negotiations and finalization.

Key Responsibilities

• Analyze claims and confirm cover, ensuring accurate and timely processing of claims.
• Draft rejection letters if necessary, maintaining strong communication with brokers and stakeholders.
• Request and analyze policy files and related documentation, providing expert insights to inform decision-making.
• Appoint assessors when required, working closely with experts to ensure thorough and efficient claim resolution.
• Capture and register claims, ensuring seamless tracking and management throughout the process.
• Settle claims within mandate, applying sound judgment and expertise to achieve successful outcomes.
• Recover third-party claims, utilizing negotiation skills to secure optimal results for both parties.
• Prepare payments files on successful recovery, ensuring accurate and timely settlement.
• Finalize claims according to Old Mutual Insure standards, maintaining high levels of quality and efficiency.

Accountability & Urgency

This role demands extreme urgency and attention to detail, requiring you to prioritize tasks effectively and manage multiple claims simultaneously.

Business Acumen

To succeed in this position, you must possess a deep understanding of main business drivers, impacting decision-making and driving results. You should also demonstrate financial awareness, controlling costs, and thinking in terms of profit, loss, and added value.

Teamwork

You will work collaboratively with colleagues to achieve team goals, sharing information, supporting others, and fostering a positive team environment.

Claims Processing

As a Claims Negotiation Specialist, you will have an innate understanding of claims processes, wordings, and systems, ensuring effective application and delivery of intended results, including service and costs.

Quality Driven

Maintaining high standards of quality without compromising effectiveness is crucial in this role, supporting business objectives and delivering exceptional customer service and experience.

Customer Centricity

Your ability to prioritize customer service and experience, as well as claims processes and stakeholder needs, will be essential in this position.

Decision-Making and Problem-Solving

You will apply complex reasoning skills to analyze symptomatic challenges and derive effective solutions, ensuring claims service and process continuity.

Team Player

You will work well with others, supporting peers and colleagues to foster team success and a positive work environment.

Relationship Management and Networking

You will build networks with parties that can enable achievement of team goals and objectives, successfully building trust and rapport with customers, and presenting solutions that meet customer objectives.

Requirements

To be successful in this role, you will require:

• A matric qualification
• 4 years' short-term claims experience
• Technical ability to effectively direct claims
• Understanding of claims processes and service requirements
• Appropriate insurance qualification/degree

Skills

The ideal candidate will possess skills in:

• Claims negotiations
• Claims settlement
• Client negotiations
• Settlement negotiations

Education

A Bachelor of Commerce (BComm) degree is required for this position.

Salary and Benefits

The estimated salary for this role is R550,000 per annum, plus benefits, making it an attractive opportunity for experienced professionals.