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Hybrid Specialist: Claims Negotiator bei Old Mutual

Old Mutual ·  OMInsure Head Office, Vereinigte Staaten Von Amerika · Hybrid

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Let's Write Africa's Story Together!

Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

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To provide a quality Specialist  claims service, ensure containment of claims spend and provide excellent service in setting a culture of best practice within mandated responsibility.

  • End-to-end claim processing including negotiation and settlement of Specialty Lines of Business  claims

  • Process Specialty lines claims in adherence with SLA.

  • Arrange assessment in adherence with SLA.

  • Review merit of claim.

  • Complete Risk assessment and additional support request analysis.

  • Clarify and amend information where required

  • Appoint the support service required.

  • Review Support Function Report.

  • Calculate and Analyse technical computations.

  • Capture all relevant claims updates and decisions on system.

  • Manage Diarised actions aligned to SOP

  • Prepare Rejection Letter, where required.

  • Prepare Payment with communication details.

  • Await additional information on multiple payments, if required.

  • Continuously improve claims service, manage claims spend and contain the increase in average cost of claims.

  • Improve / maintain Specialty Lines  Claims service effectively.

  • Reduce/ maintain turnaround time of Specialty Lines Claims.

  • Ensure effective implementation and compliance of claims/ operational systems or procedures.

  • Ensure diary is maintained.

  • Ensure estimates are raised accurately and timeously in accordance with best practice as and when new claims and new documents are actioned.

  • Adhere to Specialty Claims Standard Operations Procedures

  • Maintain Turn Around Times

  • Experience Knowledge Skills Required:

  • Matric

  • Appropriate insurance qualification background

  • Knowledge and interpretation of Specialty Lines  policies

  • 3 years Specialty Lines  claims handling

  • 5 years Commercial Non motor experience specifically Corporate Property, Engineering and Marine

Skills

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

Competencies

Business Insight

Collaborates

Decision Quality

Drives Results

Ensures Accountability

Financial Acumen

Instills Trust

Manages Complexity

Education

NQF Level 5 - Higher, Advance or Occupational Certificate or equivalent

Closing Date

29 July 2025 , 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.

The Old Mutual Story!

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