Claims Manager - Cape Town

 


Salary:                  R50 000 CTC per month


Location:             Cape Town CBD 



About the company:



Our Client is a leader in long-term insurance and they are seeking to employ a Claims Manager.



Responsibilities:



·         Work independently making basic disability assessment decision and to actively pursue claims management opportunities  


·         To consulting with medical and paramedical professionals in the medical and legal industry 


·         To manage a portfolio of clients which will include clients at the medium and high end of the market


·         Presentations in PowerPoint to clients on process and feedback on portfolio scheme management


·         Innovative proposals on process and business improvements e.g. re-arranging same decision letter to make it look better.


·         All claims assessment decisions within limits of
• R 1,000,000 to R 1,250,000 lump sum disability
• R 20,000 p.m. to R 25,000 p.m. Income Replacement Plan
• R 500,000 dread disease


·         Ongoing and expert recommendations on retraining, re-skilling or realignment of claimants


·         Renegotiations on reinsurance treaties and give opinions on which re-insurer will be good from a claims perspective



Requirements:



·         At least 5 years claims management experience in assessment or clinical medicine


·         Must have minimum 2 years’ experience working in Long Term Insurance industry


·         Previously handled all aspects of disability claims assessment financial risks


·         Liaised with clients, trustees and employers to present reports and make recommendations


·         Preparing replies to Ombudsman letters and issues


·         Dealt with complex situations


·         Legal experience 


 



Outputs:



·         Expert claims assessment processes


·         Dealing with complex queries


·         Making adverse decisions


·         System development


·         Negotiate terms and conditions with the reinsures


·         Long Term Insurance industry knowledge 



What to include:



1.      Detailed cv


2.      Motivational letter 


 

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