Job Description

As an admin department you are responsible for ensuring or services are properly utilized in your areas. Your area comprises of the relevant skill set/team that works together to make sales, increase profitability and build and maintain relationships with customers to encourage repeat service and brand loyalty.

You will be responsible for handling customer inquiries and claims in a prompt and professional manner, and also be responsible for maintaining accurate records and documentation.

Key responsibilities include (but are not limited to):

Investigate, process, and adjudicate claims in accordance with client regulations/SLA, as well as company policies and procedures.

Receiving new customer claims from client Setting up appointment with insured to facilitate an assessment. Schedule your team to an assessment while liaising with other Claim handlers. Time management skills to ensure that customer is attended on time. Customer service skills to be able to communicate with client and customers. Review claim documentation to determine if all information necessary for processing the claim is present. Examine claims to identify errors, omissions, or discrepancies, and take appropriate action to resolve them. Process claims within established timeframes, ensuring accuracy and completeness. Maintain up-to-date knowledge of info, as well as company policies and procedures. Communicate with claimants, providers, and other stakeholders regarding claim status and updates. Generate reports on claim activity, as well as trends and patterns. Escalate complex claims to senior staff or management as necessary. Perform quality assurance reviews on processed claims. Attention to detail is a crucial skill for claims. handle customer complaints, so it's important to be able to identify the issue and find a solution. communicate with clients, insurance representatives and other staff members. Communicating with customers about their claims status, payment amounts, and any other pertinent information Reviewing and approving settlement offers before sending them to claimants for approval. responsible for managing the claims process. ensure that all information is properly documented so that it can be used in the future as a reference point for similar claims.
Job Type: Full-time

Pay: From R8000,00 per month

Ability to commute/relocate:

Soweto, Gauteng 1804: Reliably commute or planning to relocate before starting work (Required)
Education:

Certificate (Required)
Experience:

Sales & CRM: 3 years (Required)
Language:

English (Required)
Work Location: In person

Application Deadline: 2025/06/21
Expected Start Date: 2025/07/01