Claims Handler
2 weeks ago
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
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Claims Handler
Responsible for processing and investigating insurance claims relating to customers' policies. This will involve working with the policy holder, Insurers, Brokers, colleagues and other professionals to ensure the claim is valid.
Main duties include:
- Advise clients on general queries and insurance issues
- Process new insurance claim notifications
- Register claims accurately and timely to ensure all data is captured within the relevant platforms
- Collect accurate information and documents to proceed with the claim process
- Analyse claims made by policyholders to establish whether it satisfies the policy conditions
- Guide policyholders on how to proceed with claims
- Identify reasons why policy conditions do not apply
- Correspond with network providers and approved professionals
- Monitor the progress of a claim to assist with quick resolutions
- Investigate potentially fraudulent claims
- Prepare an initial estimate of costs and closely monitor keeping records of costs
- Act on advice from external specialists, such as loss adjusters and forensic accountants, on complex cases
- Ensure fair settlement of a valid claims
- Manage WICA claims from registration to finalisation
- Detailed knowledge of the new MOM WICA legislative changes introduced 1 Jan 2020
- Assess WICA claims in line with the new MOM policy limits
- Investigate cause of loss ensuring it falls under policy coverage
- Medical Claims Knowledge
- Ensure compliance with operational, HR and H&S procedures and policies, and respond appropriately when required
- Adhere to legal requirements, industry regulations and customer quality standards set by the company
**Requirements**:
- Possess valid Basic Insurance Concepts and Principles (BCP), Personal General Insurance (PGI) and Commercial General Insurance (CommGI) certificates
- Experience in bodily injury or casualty claims would be an advantage
- Strong initiative and the ability to adapt quickly to different situations
- Strong numeracy and time management
Sedgwick is an Equal Opportunity Employer.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Sedgwick retains the discretion to add or to change the duties of the position at any time.
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