Insurance Claims Administration
Carry out a range of information gathering and data processing activities to support the administration of insurance claims, including an initial review of claims documentation to identify further information needed and/or to allocate cases to the appropriate claims specialists/investigators.
Document Management
Create, organize and maintain files containing the correspondence and records. Obtain all required information and documents to proceed with the claim.
Administration
Produce, update and provide best practice support on a wide range of MS documents, databases and other departmental systems to support the work of more senior colleagues.
Intermediary / Customer Service Management
Carry out standard intermediary / customer service activities and handle simple customer enquiries.
Stakeholder Engagement
Support stakeholder engagement by arranging actions, meetings, and events.
Compliance
Work within standard compliance systems and report simple non-compliance issues. Comply with service level agreements and quality standards.
Personal Capability Building
Maintain and build relevant knowledge and ensure effective updating of own product and system knowledge. Develop and maintain excellent process or technical skills by participating in assessment and development planning activities as well as formal and informal training and coaching.
Continuous Improvement
Contribute to optimising work practices and procedures and generate new ideas to assist in identifying continuous improvements and growth for broker's.
Data Management
Support others by working on a variety of data management tasks.
Performance Management
Assure all work meets technical / operations standards for quality and timeliness; use performance management systems to improve personal performance.
External Communications
Create positive experiences for clients by interacting courteously with them.
BEHAVIORAL COMPETENCIES
Customer Focus
Builds strong customer relationships and delivers customer-centric solutions. For example, keeps in contact with customers to ensure problems are resolved, or to improve customer service. Studies customer feedback and emerging customer needs and uses these to determine some creative new ideas.
Builds Networks
Effectively builds formal and informal relationship networks inside and outside the organization. For example, draws upon own network to gain insight, build support, and achieve outcomes. Leverages networks to identify industry experts, explore some best practices, and exchange ideas and knowledge.
Interpersonal Savvy
Relates openly and comfortably with diverse groups of people. For example, takes time to build rapport in meetings; speaks about common interests and priorities; shows tact and sensitivity in difficult interpersonal situations. Maintains productive relationships with a wide variety of people and from a range of backgrounds.
Collaborates
Builds partnerships and works collaboratively with others to meet shared objectives. For example, readily involves others to accomplish goals; stays in touch and shares information; discourages "us versus them" thinking; shows appreciation for others' ideas and input.
Drives Results
Consistently achieves results, even under tough circumstances. For example, devotes considerable effort to surpassing goals and achieving the best possible results; goes above and beyond to achieve excellence. Drives ahead with great focus when faced with obstacles and setbacks; maintains productivity and a positive attitude.
Ensures Accountability
Holds self and others accountable to meet commitments. For example, holds self to high standards and consistently honors policies, procedures, and work requirements. Scrupulously ensures all work is correct.
Persuades
Uses compelling arguments to gain the support and commitment of others. For example, gives many insightful suggestions and offers thoughtful positions, once informed about the issues. Thinks carefully and solicits insight into how to build a compelling argument that resonates with others' interests.
Communicates Effectively
Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences. For example, listens attentively and takes an interest. Keeps others well informed; conveys information clearly, concisely, and professionally when speaking or writing.
Plans and Aligns
Plans and prioritizes work to meet commitments aligned with organizational goals. For example, outlines clear plans that put actions in a logical sequence; conveys some time frames. Aligns own work with relevant workgroups. Takes some steps to reduce bottlenecks and speed up the work.
Action Oriented
Takes on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm. For example, identifies what needs to be done and acts quickly. Shows optimism and enthusiasm that affects others positively. Works independently, but knows when to ask for help.
Being Resilient
Rebounds from setbacks and adversity when facing difficult situations. For example, skillfully handles disruptions, obstacles, and emotional or stressful situations and nevertheless makes steady progress; seeks insight into the situation, reduces tensions, and finds optimal solutions. Swiftly recovers from
significant setbacks.
Manages Complexity
Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. For example, gathers basic information to understand a problem and find a solution. Seeks to understand and apply systematic problem-solving methods; distinguishes symptoms from underlying problems.
Instills Trust
Gains the confidence and trust of others through honesty, integrity, and authenticity. For example, demonstrates integrity, upholding professional codes of conduct. Instills trust by following through on agreements and commitments despite competing priorities and by being honest and straightforward.
Manages Conflict
Handles conflict situations effectively, with a minimum of noise. For example, seeks out a variety of opinions and options; maintains an open mind; takes steps to ensure conflict remains constructive; avoids polarized or unilateral decisions; seeks agreement on critical issues.
Skills
Intermediary / Customer Service Delivery
Works without supervision while providing technical guidance as needed on meeting high customer service standards.
Verbal and Written Communication
Use clear and effective verbal and written communication skills to express ideas, request actions and formulate plans or policies.
Attention to Detail
Apply concepts of knowledge / skill to pay attention to details.
Data Management
Works under guidance (but not constant supervision) to acquire, organise, protect and process data to fulfill business objectives.
Product Management
Works with guidance (but not constant supervision) to manage and develop all aspects of a product or service so that it achieves its maximum impact and value in the market.
Computer And Software Skills
Support business processes by understanding and effectively using standard office equipment and standard software packages.
Excel, Microsoft Word
Planning and Organising
Plan, organise, prioritise, and oversee activities to efficiently meet business objectives.
Action Planning
Develop appropriate plans or perform necessary actions based on recommendations and requirements.
Policy and Regulation
Works without supervision and provides technical guidance when required on interpreting and applying knowledge of laws, regulations and policies in area of expertise.
Data Collection and analysis
Analyse data and information to help guide decision making.
Negotiation
Negotiates under guidance (but not constant supervision) to help the organization by obtaining consensus between two or more internal or external parties who may have different interests.
Review and Reporting
Works with guidance (but not constant supervision) to review and create relevant, lucid and effective reports.
Conflict Management
Applies concepts of knowledge / skill and requires guidance but not constant supervision.
EDUCATION
General Education
- Grade 12/ SAQA Accredited Equivalent (Essential)
- FAIS and RE5 qualification (Essential)
- Class of Business product knowledge (Essential)
General Experience
- 1 3 years Financial Services industry experience (Essential);
- Short-term insurance product knowledge / intermediary experience (Advantageous); ROC experience (Advantageous)
- 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 BusinessCertification 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.
