Claim consultants

Job Ref #: C0090502
Industry: Academic
Job Type: Permanent
Positions Available: 14

TIH is the holding company of some of South Africa’s leading financial service providers. Our portfolio includes short-term insurers, a long-term insurer, health insurance as well as an insurance and personal finance comparison platform. We’re pioneers with a hunger for best, bringing customer-focused innovation and service excellence to the financial services industry.

Job Description

JOB PURPOSE

Process already-captured claims efficiently and accurately through drawing on the relevant criteria to ensure standardisation across the organisation to enable decision making on a claim.

 

RESPONSIBILITIES

  • Customer Management (Internal)
  • Help manage customer by carrying out standard activities to complete the customer request.
  • Data Collection & Analysis
  • Ask questions, collect data from a variety of sources, analyse information and investigate claim.
  • Make decisions according to established criteria to ensure standardization across the organisation by accurately administrating and underwriting claims.
  • Use appropriate tools to accurately cost applicable claims on a day to day basis.
  • Work Scheduling and operational compliance
  • Organise own work schedule in order to get the job done, coordinating with support services and completed work within SLA

 

TASKS

  • Prepare insurance claim forms or related documents and review them for completeness.
  • Enter claims information into database systems.
  • Pay small claims.
  • Calculate quantum amount of claim.
  • Post or attach information to claim file.
  • Transmit claims for further investigation.
  • Contact insured or other involved persons to obtain missing information.
  • Review insurance policy to determine coverage.
  • Organise or work with detailed office records, using computers to enter, access, search or retrieve data.
  • Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
  • Finalise claims and communicate the outcome to the customer
  • Listen and transcribe client conversations
  • Request Client Conversation
  • Retrieve Client Conversation
  • Issue repair / replace vouchers
  • Load and action 15 minute messages
  • Complete Things To Do (TTD’s) and requests
  • Refer to Loss Adjuster when required
  • Arrange to collect salvage – Non-Motor where applicable
  • Arrange to collect salvage – Motor where applicable
Job Requirements

General Education

Matric / Grade 12/ SAQA Accredited Equivalent (Essential)

 

General Experience

1 or more years’ Financial Services industry experience (Essential); Call Centre

Experience (Essential); STI experience (Advantageous); 1 or more years’ Claims

Experience (Advantageous); At least 2-3 years’ experience in a Customer Service environment (Advantageous)

Apply here

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