Claims Administrator at Rand Mutual - RMA

The Job at a Glance

As the Claims Administrator, you will be reporting to the Team Leader: Claims Administrator. You will be responsible for capturing of claims, following up on outstanding documents from relevant stakeholders and indexing of documents. You will also be responsible for keeping stakeholders informed and updated via various channels i.e. email, telephone, SMS etc. throughout the various stages of the claims processing cycle. In addition, you will also be responsible for the day-to-day operations of the branch premises where applicable, manage queries from walk-in clients and channel stakeholder queries according to the Service Level Agreement.

WHAT WILL YOU DO?

Claims Administration:

• Acknowledgement of claims upfront, distinguish between minor and serious injuries and products
• Communicate and articulate the claims process and requirements to the claimants and employers, as pre-defined processes
• Refer / channel claims to relevant departments
• Gather information, send follow-ups and reminders on outstanding claims documents
• Prepare, scan, and index internal and external documents i.e. medical reports, invoices, investigation reports, images, received from clients according to company procedures and Service Level Agreement
• Organise scanned documents on the local network
• Identify and edit/correct the legibility of scanned documents
• Analyse documents received to produce the appropriate shades and best resolution in scanned reproductions
• Ensure that there are no duplicate documents uploaded on the system on an ongoing basis
• Assist in checking the eligibility and validity of the Employer
• Perform any other ad hoc duties as assigned
• Provide backup services for team members
• Capture Temporary Total Disablement for payment.

Query resolution:

• Manage and resolve customer enquiries
• Identify and escalate priority issues
• Act as backup for the Contact Centre for email\calls overflow and during system downtime.

Branch / Team Administration:

• Carry out all office planning on a regular basis, as issues arise, or in advance of anticipated needs
• Continuously ensure proper housekeeping, safety and security of the Rand Mutual Properties
• Compiling records of office activities i.e. keep an electronic and manual register of walk in clients
• Order and maintain relevant office supplies
• Arrange team meetings and distribute minutes.

Customer Service:

• Regularly communicate and liaise verbally and in writing with customers/suppliers/visitors/enquirers and relevant staff, and interpret and respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions
• Manage walk-in queries as and when required in line with the RMA Service Catalogue
• Handle customer inquiries both telephonically and by email
• Research required information using available resources
• Provide customers with accurate product and service information in an efficient manner
• Update existing customer personal information
• Deal with all customers in a professional and empathetic manner
• Assist stakeholders with using the correct processes for logging their queries.

Reporting on progress:

• Using appropriate templates and channels to report progress as and when required.

WHAT YOU'LL BRING TO THE TABLE?

• NQF Level 5 Higher Certificates and Advanced National (vocational) Certificate in business administration or commerce
• 2-3 years clerical, scanning and indexing experience required
• Data-entry experience and good typing skills
• Additional insurance related qualifications or training will be advantageous
• Knowledge of administrative and clerical procedures
• Computer literate – Intermediate MS Office Suite
• Knowledge of customer service principles and practice
• Good Administrative skills
• Deadline driven
• Additional insurance related qualifications or training will be advantageous
• Insurance and/or Medical Aid experience
• Knowledge of Claims processing, approval.