Brief Description:A well renowned entity in the financial services industry is currently looking for a Claims Manager. Job Description:A well renowned entity in the financial services industry is currently looking for a Claims Manager.Duties in the role:Manage claims and administration costs.Proactively manage individual claims from notification to closure.Proactively supervise the proper adjudication of claims.Handle complex and fraudulent claims.Ensure that all payments are correct and in accordance with company and legislative requirements.Feedback claims trends and developments and their potential impact on claims costs.Monitor the medical Management of claims aligned to treatment protocols and COIDA limits and work with the Clinical team to generate Authorization of treatment plans and devices.Management of Cost associated to the authorization and claims Estimates.Ensure that claims are Reviewed and recommendation for TTD Payment, Lump Sum payment or Pension are made.
Responsibilities + Skills
Computer literacy: Advanced MS Word, Excel and OutlookGood presentation skills and ability to interact with management
Administration/Insurance/Health or equivalent OR Medical degree preferably within Occupational Health
Minimum of 10 years supervisory experience within the Insurance industryFAIS Regulatory Examination (RE1)