Claims Administrator at Discovery Limited

Job Purpose

• A claims administrator, captures and registers a claim on client submission. The claims administrator with evaluate the validity of the claim and the verification of documents submitted with the claim. Key responsibilities include query and complaints handling and resolution, ensuring accurate and timely processing of claims related to death, disability, retrenchment as per the policy.

Areas of responsibility may include but are not limited to 

• Managing the process of registering new customer claims
• Reviewing registered claims to assess validity against policy terms and to ensure accuracy and minimise error rates
• Validating and verifying claim information and client data to ensure accuracy
• Assessing claims in the agreed turnaround times
• Monitor the progress of claims and provide regular feedback to clients
• Flag suspicious or potentially fraudulent claims for further investigation
• Assist in compiling claims related reports and analysis for management
• Uphold service levels agreements to maintain operational excellence
• Communicating with clients and other stakeholders during the claims process
• Contribute to process improvements and ensure best practices are followed
• Update and maintain records
• Liaising with key stakeholders
• Policy verification
• Query and complaint resolution
• Manage client communication
• Accurate data capturing and verification of information during the claims capture and submission

Personal Attributes and Skills

• Verbal and written communication.
• Planning and organising.
• Problem solving.
• Time management.
• Attention to detail.
• Judgment and decision making.
• Conflict management.
• Innovative process management.
• Client service.
• Analytical and numerical.
• Understanding of all related regulatory and compliance acts.
• Claims processing.
• Record keeping.
• Data management.

Education and Experience 

• Grade 12
• 2-5 years’ experience in assessment credit applications/claims administrator experience
• Proficient in MS office
• Ability to compile information and prepare reports
• Strong ability to work under pressure
• Excellent administrative and organization skill with strong attention to detail
• Professional, with a client centric approach and focused on client service excellence