Our client in the Insurance sector is well known as a Funeral Insurance Product & Administration Specialist, providing A to Z product capability (risk pricing, wording, risk management, membership/claims administration,and fulfillment). And they are seeking a Claims Assessor to join their team.
Duties & Responsibilities
Your job requirements include but are not limited to the functions below.
Full and accurate assessment of all claims documents, specifically that all the requirements have been received and that all fraud checks were done.
Confirming the validity of the policy and the quantum of cover.
Ensuring appropriate telephonic confirmations with external parties (undertaker, police, government mortuary, hospital etc) are done timeously.
Ensuring all claim notes and information relevant to a specific claim are updated correctly on the system.
Maintaining professional telephonic and written communication with customers, both external and internal.
Maintain confidentiality – client and Company
Assisting with special projects when asked to.
Attendance at all Company training and functions.
Escalation of serious issues to either your supervisor, manager or failing them,
General Manager or Managing Director.
Referral of all matters entailing legal litigation, or possible legal litigation to your manager, or failing that the Legal Department.
Correct completion and use of all Company documentation as may be provided to you.
Appropriate and correct use of all Company facilities and tools as may be provided to you.
Compliance with appropriate dress code and standards of personal hygiene, neatness and conduct.
Any other function, duty, target or standard as required by the company, and as may be amended from time to time.
Desired Experience & Qualification
Good judgement & decisiveness
Good problem solving and investigating skills
The candidate must be reliable, and results orientated.
Ability to work independently as well as being a good team-player with excellent interpersonal skills
Experience in the Life Insurance industry
2 years’+ experience
Case Management experience is an advantageous
Proficient in the assessment and management of claims
Must understand claims environment and general claims protocols and processes