Job Description

The Claims Consultant contributes to the Organizational goals by validating, assessing and finalizing claims within policy guidelines and performing all claim related functions in a manner that promotes the achievement of Company objectives and service excellence.
Key Objectives, Duties and Responsibilities:

• Ensure claims are handled accurately as per policy schedule of benefits
• Capture relevant information accurately to enable colleagues to follow-up and assist clients
• Ensure reference material / notes on claim file updated
• Assess, validate and process claims to prevent fraudulent incidents
• Liaise with customers, third parties and internal stakeholders from a claim administration perspective (Telephonically, face to face and in writing in a timeous manner throughout the duration of the claim)
• Ensure claims are finalized within prescribed time frames
• Ensure that the required documentation is completed accurately and thoroughly in order to assist with the efficient finalization of claims
• Ensure that queries and complaints are resolved timeously
• Follow up on outstanding diary items/queries/claims with relevant divisions until completion

Education Requirements/ Experience:

• Matric / Grade 12
• Microsoft Office skills, i.e., Outlook, Excel and Word are mandatory
• Minimum 2 years claims experience, specifically in motor vehicle, accident damage or panel beating industry
• Knowledge of Short-Term Insurance
• RE5 will be advantageous
• Extensive knowledge of the Life Insurance Industry
• Experience within the Claims environment would be advantageous

Knowledge and Skill Requirements:

• Deciding and initiating action
• Working with People
• Adhering to Principles and Values
• Presenting and Communicating Information

• Collaboration and teamwork
• Learning and Researching
• Delivering Results and Meeting Customer Expectations
• Following Instructions and Procedures
• Adapting and Responding to Change
• Coping with pressure and setbacks
• Achieving Personal Work Goals
• Self-motivated

• An advanced level of understanding of motor vehicle panels
• An advanced level of Communication Skills (verbal & written)
• An intermediate level of conflict handling and resolution
• Own and live up to company values

Skills Required