Claims Administrator

Pps Recruitment; Gauteng; On-site; ZAR 300 000 - 420 000; Full time

Job summary

A recruitment firm in South Africa is seeking a candidate to coordinate and assist with administrative aspects of the claims process. The role requires strong communication and customer service skills, and the ability to resolve queries efficiently. The ideal candidate should have a Grade 12 education and experience in claims administration, with a focus on delivering exceptional service to policyholders.

Qualifications

• Experience in a claims administration environment.
• Experience in the policy administration environment would be beneficial.
• Call Centre experience would be beneficial to assist with telephonic enquiries.

Responsibilities

• Assist in the processing of claim payments, settlements, and reimbursements.
• Provide exceptional customer service to policyholders throughout the claims process.
• Combat insurance fraud by ensuring strict compliance to mandates and procedures.
• Handle claim complaints and resolutions.
• Uphold service excellence principles as communicated by management.

Skills

Strong communication skills (written & verbal)

Strong customer service skills

Strong attention to detail

Strong analytic and problem-solving skills

Computer literate (Microsoft Suite)

Education

NQF Level 4: Grade 12

Job description

Job Advert Summary

Co-ordinate and assist with the administrative aspects of the overall claims process support for personal lines and commercial claims. Must have the ability to process in all facets of the Short Term Claims department and resolve queries from start to end. Delegate authority to manage the process and resolve any conflict between various role players internally and externally. Administer duties correctly and efficiently within the specifications of PPS Short-Term Insurance Company's policy terms and conditions.

Minimum Requirements

Education:

• NQF Level 4: Grade 12

Experience:

• Experience in an claims administration environment.
• Experience in the policy administration environment would be beneficial.
• Call Centre experience would be beneficial to assist with telephonic enquiries.

Knowledge and Skills:

• Strong communication skills (written & verbal).
• Strong customer service skills.
• Service driven, with a focus on accuracy and quality of information delivered within service levels.
• Strong attention to detail.
• A strong work ethic and a drive to exceed expectations.
• Strong analytic and problem-solving skills.
• Adaptability to different stakeholders, audiences, and environments.
• Computer literate (Microsoft Suite)

Competencies:

• Adapting and responding to change.
• Be solution driven and take accountability and responsibility of own work.
• Persuading and influencing.
• Deciding and Initiating Action.
• Collaboration.
• Coping with pressure.

Key Responsibilities

• Assist in the processing of claim payments, settlements, and reimbursements.
• Coordinate with accounting and finance departments to ensure accurate and timely disbursement funds to policyholders or third-party claimants.
• Customer Service and Support: Provide exceptional customer service to policyholders throughout the claims process.
• Co-ordination and support between all role players – internal and external.
• General administration assistance required in efficiently and timeously processing of claims.
• Claim Complaints handling and resolution.
• Process optimization and efficiencies: Duties include working with cross-functional teams to deliver exceptional service to all intermediaries/members as set out in the relevant service level agreements.
• Combat insurance fraud by ensuring strict compliance to mandates, set procedures, philosophies and Company rules and regulations.
• Uphold all service excellence principals as communicated by management.
• Stakeholder Management: Build and maintain relationships with internal and external stakeholders.
• Collaborate effectively with peers to achieve business results.