Life Claims Administrator 12 Months Fixed Term Contract at Rand Mutual - RMA

Purpose

Reporting to the Claim Manager Life, the Life Claims Administrator will be responsible for the capturing of claims, following up on outstanding documents from relevant stakeholders and indexing of documents. They 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.

Qualifications and Experience Required:

NQF Level 5 Higher Certificates and Advanced National (vocational) Certificate in business administration or commerce

Additional insurance related qualifications or training will be advantageous.

2 - 3 years clerical, scanning and indexing experience required

Key Areas of Responsibilities:

• Managing of claims notification
• Registration of claims within agreed SLA
• Acknowledging of claims within the agreed SLA
• Communicate and articulate the claims process and requirements to the claimants, employers and brokers, 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. claim forms and supporting documents, 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 policies.
• Perform any other ad hoc duties as assigned.
• Provide backup services for team members.
• Manage and resolve customer enquiries.
• Identify and escalate priority issues.
• Carry out all office planning on a regular basis, as issues arise, or in advance of anticipated needs.
• Compile records of office activities i.e. keep an electronic and manual register of walk in clients.
• 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
• Handle customer inquiries both telephonically and by email.
• 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 and claim registration.
• Use appropriate templates and channels to report progress as and when required.

Knowledge, Skills and Competencies Required

• Insurance and/or Medical Aid experience
• Knowledge of Claims processing, approval
• Knowledge of business policies, processes and procedures, legal compliance and claims environment
• Data-entry experience and good typing skills
• Knowledge of administrative and clerical procedures
• Computer literate – Intermediate MS Office Suite
• Knowledge of customer service principles and practice
• Good Administrative skills
• Deadline driven
• Service Orientation / Customer Responsiveness
• Verbal and written communication
• Building Relationships
• Networking
• Negotiation and Persuasive Skills
• Interpersonal awareness / empathy
• Stress handling
• Numerical reasoning
• Attention to detail
• Word fluency and understanding (in both verbal and written communication)
• Process Engineering and Systems Competence