A vacancy has become available for a Claims Assessor: Short Term in the Umhlanga area, Responsible for validating, evaluating, making the correct assessment decision and calculating the correct payment for Short Term Claims assessed.
- Confirm that the claim intimation is correct and valid.
- Check the status of the policy & receipt of premium (current and up to date), to facilitate claim processing.
- Responsible for ensuring that all the required supporting documentation is obtained to comprehensively assess the claim.
- If necessary, requesting the Claims Administrator to source outstanding documents.
- Responsible for evaluating and assessing the claim as per the policy wording/requirements documented in the policy wording.
- Support all involved stakeholders with regards to claim queries.
- Ensure that all interactions and developments are well documented on CADi.
- Ensure optimal use of MOS to manage workload.
- Responsible for generating payment requisitions to facilitate claim payments.
- Assume overall responsibility for the content of the decision notification sent out to all relevant parties.
- Ad hoc related administration related to short-term claims.
- Responsible for providing excellent service to policy holders and business partners in respect of Claims.
- Responsible for providing supportive input to Customer Experience with regards to customer complaints.
- Liaise with policy holders regarding the status of their claim and keep them informed if necessary.
- Responsible for maintaining the service level standards agreed with our business partners as per our SLAs.
- Responsible for ensuring that the principles of TCF are embodied in our assessment process/decision.
- FAIS accreditation is an advantage
- A recognised financial qualification (i.e. a degree or diploma) is required.
- An excellent understanding of financial concepts is required.
- Approximately 3 to 5 years related work experience, depending on the qualification attained and the nature of the work experience.