Rand Mutual Holding (Pty) Ltd - Parktown, Gauteng
Job Description:
Purpose of the role
Reporting to the Team Leader: Claims Administrator, the incumbent will be responsible for capturing of claims, following up on outstanding documents from relevant stakeholders and indexing of documents. When required, the Claims Administrator will also deal with customer inquiries, by walk-in, telephonically or email.
Qualifications and Experience Required:
- Matric
- NQF Level 5 in business administration or commerce
- Additional insurance related qualifications or training will be advantageous
- Data-entry experience and good typing skills
- 2 to 3 years clerical, scanning and indexing experience required
- Computer literate – Intermediate MS Office Suite
- Insurance and/or Medical Aid experience
Key Areas of Responsibility:
Acknowledge 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 claims to relevant departments
Gather information, send follow-ups and reminders on outstanding claims documents
Prepare, scan, and index internal and external documents according to company procedures and service level agreements
Capture Temporary Total Disablement for payment
Act as backup for the Contact Centre for email\calls overflow and during system downtime.
Carry out all office planning, house-keeping on a regular basis, as issues arise, or in advance of anticipated needs
Order and maintain relevant office supplies when required
Arrange team meetings and distribute minutes
Assist prospective clients with the completion and acceptance of new business-related documents
Handle customer inquiries, by walk-in, telephonically or email
Communicate in writing or verbally 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
Knowledge, Skills and Competencies required:
Knowledge of administrative and clerical procedures
Knowledge of customer service principles and practice
Knowledge of business policies, processes and procedures, legal compliance and claims environment
Knowledge of Claims processing, approval
Process Engineering and Systems Competence
Verbal and written communication
Good Administrative skills
Building Relationships
Networking
Negotiation and Persuasive Skills
Interpersonal awareness / empathy
Deadline driven
Stress handling
Numerical reasoning
Attention to detail
Word fluency and understanding (in both verbal and written communication)
