Motor Claims Service Quality Analyst at Santam Insurance

Job Description

Santam’s Digital Assessment department has a position available for a Motor Claims Service Quality Analyst based in Auckland Park.

The primary purpose of this position is to provide value adding quality assurance and auditing functions to assist management. As well as to detect and minimise lost economic opportunity in order to reduce Santam's exposure to loss of revenue and to provide input on effective control measures in the environment.

Key Responsibilities

• Claims analysis
• Identify process breakdowns and provide feedback and input on any process deviation and or improvements
• Monitor ex gratia payments (i.e. where a policy branch overrides the decision of the claims branch)
• Ensure that claims payments and registered claims are not duplicated
• Ensure that monthly premiums are not refunded without appropriate authorization and verify the validity of the claim in respect of claims registered after policy cancellation
• Attend to reports in respect of claims lodged
• Ensure correct estimates were provided, payments are processed timeously
• Follow up on outstanding invoices, monitor the claims movement and summarise claims accordingly
• Perform random audits on Diary Status’
• Ensure that all unpaid premiums are followed up and approved.
• Understand the processes concerned with identifying and responding to process and claims risk
• Conduct audits on the claims process
• Where adverse trends in avoidable losses are identified, implement initiatives through the Management Team, including coaching and guiding the business unit
• Monitor and ensure that all re-opened claims are valid
• Analyse and interpret risk management reports
• Ensure that the correct access levels are granted per job function
• Keep up to date on internal and external developments and practices to ensure their input and advice is appropriate and forward looking
• Help to ensure that the Incident Management area operates in accordance with relevant regulatory and legal requirements and works to ensure that awareness of such requirements is raised and promoted throughout this area
• Collaborate on initiatives / projects
• Evaluating and measuring customer satisfaction and other
• performance outcomes
• Complete Evaluation & Moderation on business processes & SOP’s

Minimum Requirements

Qualifications And Experience

• Grade 12
• Advanced computer literacy (Excel)
• 3-5 years’ experience in short term Commercial and Personal Insurance
• Audit or quality assurance experience
• Investigative/analytical experience
• Relevant systems knowledge (Persetel, JDE and BI)

Skills

• Ability to work under pressure
• Good communication skills (verbal & written)
• Basic knowledge of applicable software to infer statistical data
• Excellent analytical abilities to grasp the key points from complicated details
• Good negotiation skills with customer-oriented attitude
• Effective communication and report writing skills
• Auditing Skills
• Computer Literacy (Advanced Word, Excel & Outlook)

Knowledge

• Technical Knowledge of total motor vehicle repair process
• Product Knowledge
• Basic knowledge of applicable software to infer statistical data
• Expert understanding in how to use Audatex/Abuntex systems
• Working knowledge of short term insurance policies and practises

Competencies

• Client-focused service orientation
• Obtaining and analysing information
• Logical reasoning
• Learning orientation
• Relationship management
• Self-management and initiative
• Self-assertiveness
• Integrity
• Planning and Organising.