Process already-captured claims efficiently and accurately through drawing on the relevant criteria to ensure standardisation across the organisation to enable decision making on a claim. Assist with any adhoc administrative tasks and provide support the Inbound Team as and when required.
Responsibilities
Customer Management (Internal) Respond to customer emails and ensure follow up calls where required in a professional manner. Manage and resolve customer complaints and provide product and service information to customers. Identify customer claims and route calls to appropriate department. Help manage customer by carrying out standard activities to complete the customer request. Analyse and respond to emails received, ask questions and probe for clarity to gather relevant information to assist in resolving customer complaint or request.
Data Collection & Analysis
Ask questions, collect data from a variety of sources, analyse information andinvestigate claim. Make decisions according to established criteria to ensure standardisation across the organisation by accurately administrating and underwriting claims. Use appropriate tools (ITC, 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 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. Update policy information e.g. change of address, change policy holder details, banking details and attend to the customer request on a range of policy related issues.
Correspondence
Respond to routine requests using telephonic conversation or emails (internal and external). Ensure regular feedback to services department and other stakeholders, as determined by the company and/or customer requirements to ensure customer receives appropriate feedback from the services department.
Document Management
Create, organise and maintain files containing the correspondence relating to policies and matters.
Document Preparation
Prepare and manage claim documentation for customers. Personal Capability Building Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.
EDUCATION
General Education
Matric / Grade 12/ SAQA Accredited Equivalent (Essential); Regulatory exam 5 (Advantageous); STI Qualification (Advantageous); Class of Business (Advantageous); Customer Service certificate/or related qualification(Advantageous).
Experience
General Experience
1-3 years Financial Services industry experience (Essential); 2 or more years customer service experience (Essential); 1 year call centre experience in Financial services industry (Advantageous); STI experience and VAPS experience (Advantageous).
Additional Information
- SAQA Accredited Equivalent - it is the onus of the applicant to provide TIH and its subsidiaries with certified evidence that their qualification(s) meet the equivalent NQF level required for this role at time of application.
- Financial Sector Conduct Authority (FSCA) competency requirements: FAIS recognised qualifications / Regulatory Examinations / Class of Business Certification and / or CPD according to your DOFA (where applicable). As a registered Financial Service Provider, we are mandated to ensure that all our representatives are and remain fit and proper at all times. By applying for this role, you consent to having your relevant qualification and or accreditation or confirm that you are working towards meeting the competency requirements. You further consent to the relevant information being verified.
