Insurance Claims Clerk

Tower Group South Africa (PTY) Ltd; Durban; On-site; ZAR 200 000 - 300 000; Full time

Job summary

A leading insurance provider in Durban seeks an Insurance Claims Clerk to manage and process insurance claims accurately while ensuring compliance with both company policies and regulatory requirements. The ideal candidate will have experience in claims processing and strong communication skills to provide excellent service to clients. This role offers a dynamic work environment focused on improving client experience and operational efficiency.

Qualifications

• Proven experience in processing and managing insurance claims.
• Knowledge of insurance policies and regulations.
• Excellent communication and customer service skills.

Responsibilities

• Process, review, and manage insurance claims accurately.
• Maintain organized records and ensure confidentiality.
• Serve as a point of contact for claim inquiries.

Job description

Role Summary:

The Insurance Claims Clerk is responsible for processing, reviewing, and managing insurance claims accurately and efficiently. The role ensures compliance with company policies and regulatory requirements while providing high-quality service to clients and stakeholders.

Key Responsibilities:

Claims Processing:

Receive, review, and process insurance claims submitted by clients.

Verify that all required documentation and information are complete and accurate.

Enter claim data into the company’s claims management system promptly and accurately.

Documentation & Recordkeeping:

Maintain organized and up-to-date records of all claims, correspondence, and supporting documents.

Ensure confidentiality and secure handling of sensitive client information.

Communication & Customer Service:

Serve as a point of contact for clients regarding the status of their claims.

Communicate with internal departments, adjusters, and external parties to gather necessary information.

Respond to client inquiries in a professional and timely manner.

Claims Verification & Investigation Support:

Conduct preliminary checks to verify claim legitimacy.

Identify discrepancies, missing information, or potential fraudulent claims and escalate to the supervisor.

Assist claims adjusters in investigations, if required.

Compliance & Reporting:

Ensure all claims are processed in accordance with company policies, procedures, and relevant insurance regulations.

Prepare and submit claims reports as requested by management.

Assist with audits and regulatory compliance documentation when required.

Continuous Improvement:

Identify opportunities to improve claims processing efficiency and client experience.

Stay updated on industry trends, insurance regulations, and company policy changes.