Claims Consultant at Alexander Forbes

Job Description

Main Purpose

To process claims by providing excellent service to clients and through this retain the client and improve the company’s image so that we attract more clients.

Handle the claims process from start to finish, offering claims services to direct clients and brokers. Prioritise emergency claims and ensure that claims costs are contained and managed. Ensure correct documentation is obtained. Adhere to times frames set out in the “Service charter” in order to maintain expected service levels

Requirements

• Matric
• COP/FAIS personal lines credits
• 2 years claims experience – motor and household
• Bilingual
• Computer literate
• Customer Service experience

Key Compentencies

• Provide Client Service and Communication services
• Adhere to the guidelines outlines in the communication charter.
• Respond to client e-mails within set turnaround times
• Return phone message within set turnaround times
• Maintain client relations by being proactive and keeping clients informed
• Perform effective time management
• Utilize a diary system to track follow ups

Process Claims

• Process the required number of claims as set out in performance agreement
• Load all claims within set timeframes
• Follow guidelines and time frames set out in the service charter in all processes
• Make decisions and authorize payment of claims up to the authority value specified by company policy and procedures.
• Contain or reduce claim costs where ever possible by appointing assessors to assess the damage, putting pressure on panel beaters to reduce variable costs
• Load estimates timeously
• Escalate claims exceeding a specified value as per company policy and procedure to senior management within set time frames
• Prepare files for rejection committee
• Inform regional management and the client before handing rejection files over to the senior claims consultant for further processing
• Monitor that suppliers are paid timeously.

Resolve queries and complaints

• Resolve clients complaints and queries in line with company policies and procedures
• Identify potentially major problems and inform management of these risks
• Request assistance from management when necessary to advise on how to resolve a specific claim/problem
• Empower self proactively to better handle complaints and queries, through asking for assistance, obtaining knowledge and seeking out mentoring opportunities
• Maintain the required service level ratings through the 30x30 customer surveys to ensure efficient customer service

Work in teams

• Foster productive working relationships with the team
• Work together to ensure fair distribution of the workload
• Assist colleagues as far as possible to ensure KPA for the team are achieved
• Contribute positively to the teams working environment
• Identify opportunities to improve the team’s performance

Generate reports

• Submit weekly outstanding desk reports to the team leaders
• Submit monthly open claims reports within set timeframes
• Request monthly open claims report from the senior claims consultant and work through these daily to ensure accuracy of estimates and finalization of files wherever possible.

Technical and behavioural competencies

Knowledge and Skills

•  Product knowledge of short term insurance
•  Business writing skills
•  Telephonic communication skills
•  Listening
•  Negotiation skills
•  Time management
•  MS Office literacy

Behavioural Competencies (Interpersonal and Intrapersonal)

• Achieving personal Work Goals & Objectives
• Delivering Results & Meeting Customer Expectations
• Persuading & Influencing
• Adhering to Principles & Values
• Working with People
• Planning & Organising
• Following Instructions & Procedures
• Coping with Pressure & conflict
• Adapting & Responding to Change
• Be able to prioritise
• Hard working
• Passionate about service
• Professionalism

Cognitive Competencies

• Problem solving ability
• Organised
• Patience
• Perseverance
• Assertive
• Pro active
• Logical
• Emotional intelligence

Please only apply if you meet the requirements.