Our client, a reputable mortgage origination company is searching for a skilled individual to fill the vacancy of a Claims Consultant.
Display a clear understanding for effective Claims processing
Authorize all claims within set mandate and resolve all claims within agreed productivity targets and turnaround times, through the effective use of the claims diary system.
Apply and effectively communicate technical skills and resolve all technical matters with the use of relevant tools and systems made available.
Display a clear understanding and execution of customer complaints and resolution that need to be maintained and exceeded, together with a clear understanding of rejections of claims.
Display clear understanding of management of claims handling that need to be adhered to within the regulated agreements as set for by the relevant regulatory boards.
Ensure clear understanding of all payments and the correct application of rates to be authorized to the service provider as well as the accurate appointment of service providers to the claims.
Display clear understanding of report and quotes in order to communicate swift claims resolution to the customer.
Have a clear understanding of how to operate a claims management, together with the use of relevant tools that can enable the swift resolution of a claim and to ensure effective communication, such as operating an email from outlook, exporting own reports to excel.
Have the understanding of the internet and how to use google maps.
Have the ability to effectively plan, communicate, solve problems, and execute decision making
Have a clear understanding and accurate interpretation of the reported incident, claims history and correct application of the policy wording to ensure that all claims are treated equitably.
Ensure lateral thinking in claims handling and professional engagement with all parties when communicating technical detail to the customer, Loss Adjusters in order to consult or debate outcome of the claim.
Have an enquiring and investigative mind to communicate and report suspicious activity to next reporting level should this require further intervention.
Possess the ability to communicate in a calm yet assertive manner with difficult customers across all levels and outcomes in a fair, sensitive and persuasive manner whilst always keeping in mind to ensure that the customer has been treated fairly as regulated.
Have the clear understanding to engage and communicate with the appropriate specialist service providers to engage on each claim, if necessary, such as engineers, etc.
Practice and consistently promote effective relationship building
You are responsible to ensure that you maintain effective relations with all stakeholders within the organization.
This includes but is not limited to:
Daily relationships with:
Finance Division to improve on service delivery issues regarding payment authorizations
The company's Customer Contact Centre to assist and improve customer communication, complaints, and technical support
Policy Administration for advice of any policy amendments, client queries/requests, and complaints resolution
The company's Insurance Customer Contact Centre to provide and assist with advice on any noted anomalies or trends that could affect the processing of new claims and identify risks associated if any
Management and peers to provide daily interactions about any contentious matters and or report on urgent claims that require attention or authorization
Procurement Manager, to ensure that service providers strictly adhere to the current service level agreement
Claims Fulfillment Manager, to guide, assist and advice you of all matters that can assist you with your growth.
Communication will also be provided by your first line report in terms of urgent claims that require attention or authorisation
Operations Manager, to guide, assist and advice you through your first line report, in line with your growth and any other communication in terms of your claims
Daily relationships with:
The company's Customer to provide exceptional customer experience throughout the customer journey with the customer and to assist them professional peace of mind while dealing with queries or providing feedback proactively
Panel or non-panel service providers ensuring professional customer service interaction, with loss adjusters, quantity surveyors, forensics experts, etc. and various specialists required to complete the successful outcome of a claim
The company's representatives to provide assistance and resolve customer issues
Internal and external auditors to provide assistance during interim or final company audits
Required Language: Afrikaans
The candidate should be proficient in speaking, reading, writing and responding in Afrikaans.
The candidate should respond on technical aspects of the policy and be able to translate from reports and respond accurately to the customers accordingly.
Minimum Education Qualification:
Insurance related qualifications e.g. FETC: Short Term Insurance NQF 4, RE5
4 years Short Term insurance related experience, preferable Homeowners Claims assessment experience
5 years Short Term Claims insurance related experience, preferably with Homeowners experience
5 Years HOC Claims Experience
Excellent technical, and problem solving skills, combined with strong claims judgement and ability to communicate in a clear and compelling manner.
It is a strong requirement that the candidate have strong verbal and written communication ability.
Handle pressure, willing to work overtime. Shift work is compulsory.
Persuasive, Accurate, Decisive, Assertive, Confident, Fair, Ethical, High integrity, Reliable, Responsible,
Short term insurance claims and Customer Service orientated.
Computer Literate, Excel, Word, Microsoft Outlook, Claims Management and effective ability navigate systems.
Have the ability to comprehend and communicate technical matters, in an analytical manner.
Excellent verbal and written communication skills