Claims Processing Consultant: (Afrikaans)

Telesure Investment Holdings (TIH); Johannesburg; On-site; ZAR 180,000 - 240,000; Full time

Job summary

TIHS is seeking a Claims Processor in Johannesburg to capture and process VAPS claims, applying criteria to standardise decisions and support underwriting within SLAs.

You will manage customer requests, collect data from various sources, prepare documentation, and look for opportunities to upsell relevant products while ensuring compliance with policies.

Qualifications

• Matric/Grade 12 or SAQA equivalent is essential.
• 0–1 year experience in client services or financial services is preferred.
• Ability to capture applications and respond to client queries.

Responsibilities

• Capture and process claims accurately in line with criteria.
• Manage customer requests and provide timely feedback.
• Collect data from multiple sources and maintain documentation.
• Upsell suitable products to meet customer needs.
• Ensure work adheres to SLA and regulatory guidelines.

Skills

Customer service

Data analysis

Attention to detail

Communication

Time management

Education

Matric / Grade 12 / SAQA Accredited Equivalent

Job description

Join TIH, home to some of South Africa's leading financial service providers, and grow your career while being part of an organisation with purpose.

Job Purpose

Capture and process VAPS 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 (supplier contract and/or negotiation) 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). Ensure regular feedback to customer, service providers and other stakeholders, as determined by the company and/or customer requirements to ensure customer receives appropriate feedback from the claim department.

Document Management

Create, organise and maintain files containing the correspondence relating to policies and matters and claims to be uploaded on internal system.

Document Preparation

Prepare and manage claim documentation for customers.

Up-sell Customer Propositions

Identify a selection of products or services that may meet the customer's requirements, explain the product/service features influence the customer to add additional products/services.

Education

Matric / Grade 12/ SAQA Accredited Equivalent (Essential); Regulatory exam 5 (Advantageous)

Experience

0-1 year experience, especially client services - which includes capturing applications, instructions, reporting, and attending to IFA and client queries (Essential); Experience in the Financial Services environment (Advantageous)