Claims Negotiator - Recoveries (MVA -Motor Vehicle Accidents)
Ellahi Consulting
- Gauteng
- R23,000 per month
- Permanent
- Full-time
Salary: R23 000 per month neg plus benefits (pension and medical aid contribution)About the organisation:
- Work with driven and focused individuals, in a beautiful and harmonious office environment, 5 kilometers from OR Tambo International Airport 5 days a week.
- Multiple opportunities to exceed KPI's within SLA.
- Access to dynamic and supportive servant leadership and word class company culture within a young JSE listed company that is a leader in next generation mobility solutions.
- Thrive in a digital workspace, using a web based, world class, omnichannel, single user interface Claims system.
- Matric
- Valid Driver's license
- Relevant post matric qualification (advantage)
- 2-3 years related experience
- Claims recoveries experience (MVA - Motor Vehicle Accident Claims)
- Apportionments
- Claims negotiation
- Uninsured insurance collections
- Case law, merits, and apportionments
- Vehicle parts, repair quotations and assessments
- Review motor vehicle claims.
- Analyze portfolio of assigned claims daily.
- Prioritize claims by Quantum, Insurance, Merits and Prescription.
- Build, grow and maintain solid and valuable partnerships within the Claims industry.
- Validate supporting documents against digital checklist and upload to DMS where applicable.
- Assess merits per claim, determine degree of liability and finalise claim calculation for Recovery.
- Submit system generated LOD.
- Log sub statuses, third-party consultations, and comments.
- Receive releases, upload to DMS and diarize payment date.
- Proactively bank money within SLA to exceed KPI's.
- Computer, technology and systems skills (basic MS Office)
- Well-developed communication skills to negotiate with third parties
- Developed internal resilience (EQ) and interpersonal skills
- Developed written comprehension and reasoning skills
- Developed numerical checking and reasoning skills
- Broad solutioning and problem solving skills
- Spatial reasoning skills
- Attentive to detail
- Preference for planning and organising
- Focus on getting things done
- Concern for working within parameters
- Concern for communicating clearly
- Focus on convincing and persuading
- Remain resilient with stress and pressure
- Focus on analyzing and solving problems
- Preference for thinking practically
- Focus on initiating action
- Appreciation for challenging others with respect
- Preference for team working
- Examining information
- Convincing people
- Showing composure
- Meeting timescales
- Checking things
- Following procedures
- Managing tasks
- Documenting facts
- Interpreting data
- Adopting practical approaches
- Challenging ideas
- Team working
- Request payment from finance department and receive proof of payment within 15 working days.
- Payments received from third parties must be reconciled with the cash book and an allocation request sent to Finance daily (recoveries)
- Ensure that all liability refunds due to customers are requested on a daily basis.
- Operational
- Accept new claims from Claims Administrators at beginning of every day.
- Attend to all files on daily diary and ensure that all overdue files are attended to.
- View and action files daily.
- Update files with progress comments daily on Natural
- Determine if all documentation is accounted for, if not requested from Administrator
- Send requisition letter to the third party/draft and send a letter of demand to third party.
- Appoint assessor based on merits of the third-party case (quantum >R10 000)
- Update liability codes as per current status of the case
- Assess file for possible breach and prepare same, then forward to National Damage Admin Supervisor
- Assess merits of the case, determine degree of liability and settlement calculations/quantum calculations.
- Prepare settlement proposal.
- Refer all settlement offers received for approval to Claims Manager
- Draft settlement offer and send to third party
- If settlement is accepted by third party, request payment upon signed release.
- If settlement is rejected, negotiate terms and conditions with customer.
- Draft letter of demand based on quantum calculation and negotiate settlement with third party based on merit assessment.
- Prepare a litigation file and refer the file to Manager for approval (recoveries)
- Receive and hand over summons to Manager.
- Acknowledge receipt of summons to Attorney
- Determine if all documentation is accounted for in file if none requested from Attorney.
- Obtain authorisation for revised settlement from Claims Manager & Supervisor
- Send revised settlement advise to 3rd party Attorney.
- Receive signed revised settlement advise from third party and request payment upon receipt.
- If rejected, review the cost effectiveness of appointing an Attorney.
- If cost effective, obtain authorisation from Claims Manager & Supervisor to appoint Attorney.
- Hand over file to Attorney
- Follow up on case progress with Attorney monthly
- Proactive
- Organized
- Resilient
- Effective
- Efficient
- Exceptional verbal & written communication skills
- Excellent telephone mannerism
- Calm, composed and fast paced individual with focus on exceeding KPI's within SLA
- All correspondence is acknowledged.
- All queries and complaints are actioned.
- Attend all team huddles and meetings as scheduled
- The role requires close engagement and collaboration with key internal and external stakeholders
- Finance Team
- Attorneys, Third Parties