Claims Consultant

Bring your possibility to life! Define your career with us
With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.
Job Summary

Ensure that all Claims & Underwriting activities and duties are carried out in full compliance with regulatory requirements.
Enterprise-Wide Risk Management Framework and internal Absa Policies and Policy Standards.
• Understand and manage risks and risk events (incidents) relevant to the role.

Job Description

Ensure prompt registration and acknowledgement of new claims
Evaluate and settle claims, to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio
Confer with legal counsel on claims requiring litigation
Liaise with external service providers to assess risk e.g., claim investigators, medical doctors, assessors etc
Verify and analyse data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures
Maintain updated group risk and claims register and associated files & records as per Information Risk Management guidelines.
Payment of claims within the set service levels in service benchmarks and Service Level Agreements.
Prepare and compile weekly & monthly underwriting and claims reports enhanced with qualitative assessment; portfolio analysis, risk recommendation within the stipulated time
Approval of payment and discharge vouchers within limits
Implement fraud strategies that actively identify and prevent fraud within the area through enhancing manual process or through system enhancement improvement.
Collaboratively assess the loss ratios and report as per claims and underwriting best practice.
Quote for Group Risk products within approved guidelines and approval limits
Prepare and issue debit and credit notes
Prepare & issue cover notes and/or policy document as per onboarded risk
Ensure effective renewal process – renewal invites; costings; debit and credit notes and issue renewal endorsement
schedule
To prepare reinsurance bordereaux end-to-end
To review underwriting and claims special cases to effectively discharge Claims Best practice guidelines. Resolutions to be minuted/documented on email.
Ensure corrective action is taken on complaints received by following correct procedure and input and provided feedback for root cause analysis  & resolution and Treating Customers Fairly(TCF) principles.
Provide superior customer service by proactively and timeously obtaining outstanding documentation to ensure complete efficient claims processing
Provide underwriting and claims technical support to operation, business development and accounts departments in all phases of policy life cycle.
Have regular meetings to review statuses, claims and underwriting progress etc with insurers and all stakeholders
Query and complaint Case Management & resolution matrix  to support Customer Experience Help Desk & relationship managed business.Individual & team behavior aligned to the Absa Way Drivers for above average score on Absa colleague experience index and positive work environment for colleague engagement
To motivate high performance & the Absa way through non-monetary & monetary reward & recognition in a timely, specific and frequent manner.
MI monitoring & evaluation of performance and throughput.
Track performance output by daily throughput and TAT on processes, query & complaint resolution.
As a minimum, to participate in employee volunteering community programs

EDUCATION & QUALIFICATION CRITERIA:

BSC Actuarial, BCom (Insurance Option) or business-related degree.
Professional qualification in Insurance (ACII, FLMI or AIIK). Or good progress toward the same with a minimum of COP.
At least 1 years’ experience in insurance underwriting and claims processing in credit life, Group Risk and/or Retail Life.
Experience in analysis of financial and legal documents and data analysis.

Education
Further Education and Training Certificate (FETC): Business, Commerce and Management Studies (Required)

Apply via :

absa.wd3.myworkdayjobs.com

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