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 standardisation 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.
Ensure claims are finalised within the set parameters (turnaround time, terms and conditions applied accurately).
Remain up to date with current and new product knowledge to enable effective decision making.
Administration
Produce, update and provide best practice support to customers on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs.
Correspondence
Respond to routine requests using telephonic conversation or emails (internal and external).
Document Management
Create, organise and maintain files containing the correspondence relating to policies and matters.
Document Preparation
Prepare and manage claim documentation for customers.
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
Education
Grade 12 / SAQA Accredited Equivalent (Essential)
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).
Telesure Investment Holdings (Pty) Ltd (TIH) is the holding company of some of South Africa’s leading and innovative financial institutions.
These financial institutions are licensed to provide financial products and/or services ranging from short-term, long-term and health insurance as well as a comparison and investment platforms.
Our origins go back to 1 June 1985, when Auto & General Insurance was launched into the South African market. We have since grown into a group of subsidiaries of which Auto & General now forms a part.
Today, we own some of South Africa’s most loved and recognisable brands, each finding a better way to give their unique group of customers peace of mind.
We exist to continuously find better ways to give people peace of mind, whether it is to protect what they own, their loved ones or their greater ambitions and life plans they’re working so hard for.
We’re proven pioneers with a hunger for doing and being the best we can, bringing customer-focused innovation and service excellence to the financial services industry.
We’re an undivided team of diverse thinkers and doers who believe in leading through technology and pushing past their limits.
TIH is a licensed controlling company.
