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Job Description

Purpose of the Job Responsible for researched, records and examines coverage information to make highly complex short term claim settlement determinations.

 

• Responsible for making highly complex short term claim settlement determinations.
• Reviewing/auditing Claim Files and reserves within time standards.
• Correct understanding and application of Policy Terms and Conditions
• Daily reviewing/auditing of the claims processed and legal claims.
• Daily providing policyholders and Brokers with excellent service.
• Regularly keeping policyholders and Brokers informed on the status of their claims.
• Regularly liaise with internal support divisions, i.e. Salvages Department.
• Visiting external stakeholders.
• Continuous improvement to ensure effective service
• Actively participate in problem solving activities to define problems, assess current state root causes, design and test solutions, implement solutions, and sustain and continuously improve to permanently eliminate problems.
• Actively participates in continuous improvement by fully engaging in daily huddles, generating suggestions, following appropriate procedures and continuous process improvement work principles, participating in problem solving activities, and utilizing continuous improvement tools to support the work of the team.
• Ensure statutory and legislative knowledge is always current in order to resolve customer complaints, to advise the business on corrective solutions to mitigate risks and to improve the customer experience whilst complying with governance requirements.
• Ensure adherence to organisational policies, practices and procedures.
• Identify solutions to enhance cost effectiveness and increase operational efficiency
• Service delivery to ensure customer satisfaction
• Maintain service, quality and desired outputs within a specific functional process through ensuring compliance to tactical policies, procedures and standards.
• Establish productive operational relationships with key stakeholders in the various channels and administrative teams.
• Develop work routines in line with operational plans / schedules in order to manage achievement of service delivery goals.
• Share knowledge on, and participate in the creation of new standards, control systems and procedures to maintain service delivery.
• Cost control and governance adherence
• Proactively ensure use of time, of resources, money, materials or equipment is in line with policies and procedures.
• Comply with corporate governance policies, procedures and standards.
• Operate within agreed mandates.
• Quality people practices
• Align own behaviour with the organisation culture and values.
• Share and transfer product, process and systems knowledge to colleagues.
• Ensure achievement of own performance objectives.
• Actively share information with other team members regarding successes, issues, trends and ideas.
• Actively participate in own professional development and career path.
• Actively promote a culture of learning and high performance culture amongst team members.
• Applicants must be in possession of a post-Matric commercial qualification (NQF Level 6-7 or equivalent) or studying towards one.
• 2 years’ relevant Trade Credit or Claims experience.
• Must have accounts receivable and credit control experience.
• Debtor’s department experience will be beneficial

 

 

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Skills

Action Planning, Claims Management, Claims Settlement, Data Compilation, Data Controls, Executing Plans, Financial Auditing, Insurance Claims Investigations, Insurance Product Management, Insurance Sales, Oral Communications, Presenting Solutions

Competencies

Action Oriented

Collaborates

Drives Results

Ensures Accountability

Financial Acumen

Instills Trust

Manages Complexity

Optimizes Work Processes

Education

NQF Level 3 & NQF Level 2 - Below school leaving

Closing Date

14 October 2026 , 23:59

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

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