Reference Number MMH240327-4
Job Title Accident And Health Claims Technician
Position Type Permanent
Role Family Client Services
Cluster Guardrisk
Remote Opportunity Some of the time
Location - Country South Africa
Location - Province Gauteng
Location - Town / City Sandton
Introduction
To diligently attend to day to day and Accident and Health claims handling across various products and to provide supervisory oversight over a defined area within the short-term claims environment.
Role Purpose
To diligently attend to day to day and Accident and Health claims handling across various products and to provide supervisory oversight over a defined area within the short-term claims environment.
Requirements
- Matric
- Computer Literacy (MS Word, Outlook, MS PowerPoint, and Excel)
- Experience with Insurance Systems
- A Minimum of 60 FAIS credits
- RE exams for representatives is mandatory
- At least 10 years of working experience
- At least 7 years of insurance working experience
- Intensive knowledge of Accident and Health insurance products and claim protocols
- Sound Knowledge and experience in handling serious illness/critical illness and death claims
- Registering, Handling, and settling of Accident and Health claims in accordance with the Guardrisk applicable policies and standard operating procedures
- Managing and settling claims within required time frame as per SLAs that are in place
- Effectively negotiating with claim assessors and other related service providers
- Always providing clients/ brokers with the highest standard of service
- Providing clients / brokers with regular feedback on the claim progress
- Ensuring diary system is always implemented and adhered to daily
- Rendering of assistance with adhoc duties, when required
- Updating reserves timeously and accurately
- Attending to payment requests within the Guardrisk SLA
- Managing outstanding claims volumes
- Timely responses to email and telephonic messages
- Accurate record keeping
- Proper time keeping and task prioritization
- Provide a supervisory function over a defined area within the claims department which shall include among others
- Providing technical advice to brokers when required
- Negotiation skills
- Organizational Skills
- Effective Communicational skills
- Attention to Detail
- Ability to work effectively under pressure
- Team player
