Description:
Purpose
The successful candidate will be responsible for ensuring that all claims are handled efficiently
and that payment for valid claims are made to the claimant timeously. Involved in managing a
claim from beginning through to settlement.
Key requirements of the role – Knowledge and experience
Education and specialist skills
- Matric
- RE 5 preferably
- Post graduate diploma/degree in finance/administration
- Other insurance related qualifications
Responsibilities and KRA’s
The incumbent is expected to
- Assess validity of all claims (Mdende, EPI, Group scheme, Smart Life funeral and all
- other claims within EasyPay Insurance).
- Evaluate claims and determine requirements
- Manage own claims including complex claims
- Proactively adhere and contribute to the overall achievement of turn-around times and SLAs
- Undertakes individual claims for final reviews
- Make claim decisions according to your authority level
- Process new insurance claims notifications
- Collect accurate information and documents to proceed with a claim
- Analyse claims submitted;
- Show initiative to build and maintain knowledge of claims industry
- Monitor the progress of a claim
- Keep accurate records of all claims assessed in accordance with departmental procedures.
- Fraud detection by identifying and reporting potential fraud
- Ensure fair settlement of a valid claim
- Assist claimants on how to proceed with the claim
- Build relationships with internal and external clients
- Ensure customers are treated fairly and that the customers receive excellent service in accordance with industry and company guidelines
- Handle any complaints associated with a claim
- Adhere to industry regulations and customer quality Treating Customers Fairly
- Follow up on outstanding claims
- Process improvement, contribute to improvement of claims procedures
- Reporting, generating and Analysing claims reports to identify trends
Key competencies
- Detail orientation
- Windows
- Computer literate
- Email etiquette
- Data capturing
- Ccommunication skills
- Handle pressure
- Work independently
- Team member
- Conflict handing
- Empathy
- Flexible
- Change agent
- Solutions orientated
- Analytical thinker
- Extra hours
- Bilingual
- Training
- Organising
- Decision making Level 3 or 4
- Problem solving skills Level 3 or 4
Communication
External
- Customers
- Channels and partners
Internal
- Team members
- Supervisor
- Managers
- Exco members
- EasyPay Group
- Call Centre
- Sales
Requirements:
Purpose
The successful candidate will be responsible for ensuring that all claims are handled efficiently
and that payment for valid claims are made to the claimant timeously. Involved in managing a
claim from beginning through to settlement.
Key requirements of the role – Knowledge and experience
Education and specialist skills
- Matric
- RE 5 preferably
- Post graduate diploma/degree in finance/administration
- Other insurance related qualifications
Responsibilities and KRA’s
The incumbent is expected to
- Assess validity of all claims (Mdende, EPI, Group scheme, Smart Life funeral and all
- other claims within EasyPay Insurance).
- Evaluate claims and determine requirements
- Manage own claims including complex claims
- Proactively adhere and contribute to the overall achievement of turn-around times and SLAs
- Undertakes individual claims for final reviews
- Make claim decisions according to your authority level
- Process new insurance claims notifications
- Collect accurate information and documents to proceed with a claim
- Analyse claims submitted;
- Show initiative to build and maintain knowledge of claims industry
- Monitor the progress of a claim
- Keep accurate records of all claims assessed in accordance with departmental procedures.
- Fraud detection by identifying and reporting potential fraud
- Ensure fair settlement of a valid claim
- Assist claimants on how to proceed with the claim
- Build relationships with internal and external clients
- Ensure customers are treated fairly and that the customers receive excellent service in accordance with industry and company guidelines
- Handle any complaints associated with a claim
- Adhere to industry regulations and customer quality Treating Customers Fairly
- Follow up on outstanding claims
- Process improvement, contribute to improvement of claims procedures
- Reporting, generating and Analysing claims reports to identify trends
Key competencies
- Detail orientation
- Windows
- Computer literate
- Email etiquette
- Data capturing
- Ccommunication skills
- Handle pressure
- Work independently
- Team member
- Conflict handing
- Empathy
- Flexible
- Change agent
- Solutions orientated
- Analytical thinker
- Extra hours
- Bilingual
- Training
- Organising
- Decision making Level 3 or 4
- Problem solving skills Level 3 or 4
Communication
External
- Customers
- Channels and partners
Internal
- Team members
- Supervisor
- Managers
- Exco members
- EasyPay Group
- Call Centre
- Sales
- Matric
- RE 5 preferably
- Post graduate diploma/degree in finance/administration
- Other insurance related qualifications
- Assess validity of all claims (Mdende, EPI, Group scheme, Smart Life funeral and all
- other claims within EasyPay Insurance).
- Evaluate claims and determine requirements
- Manage own claims including complex claims
- Proactively adhere and contribute to the overall achievement of turn-around times and SLAs
- Undertakes individual claims for final reviews
- Make claim decisions according to your authority level
- Process new insurance claims notifications
- Collect accurate information and documents to proceed with a claim
- Analyse claims submitted;
- Show initiative to build and maintain knowledge of claims industry
- Monitor the progress of a claim
- Keep accurate records of all claims assessed in accordance with departmental procedures.
- Fraud detection by identifying and reporting potential fraud
- Ensure fair settlement of a valid claim
- Assist claimants on how to proceed with the claim
- Build relationships with internal and external clients
- Ensure customers are treated fairly and that the customers receive excellent service in accordance with industry and company guidelines
- Handle any complaints associated with a claim
- Adhere to industry regulations and customer quality Treating Customers Fairly
- Follow up on outstanding claims
- Process improvement, contribute to improvement of claims procedures
- Reporting, generating and Analysing claims reports to identify trends
- Detail orientation
- Windows
- Computer literate
- Email etiquette
- Data capturing
- Ccommunication skills
- Handle pressure
- Work independently
- Team member
- Conflict handing
- Empathy
- Flexible
- Change agent
- Solutions orientated
- Analytical thinker
- Extra hours
- Bilingual
- Training
- Organising
- Decision making Level 3 or 4
- Problem solving skills Level 3 or 4
- Customers
- Channels and partners
- Customers
- Channels and partners
- Team members
- Supervisor
- Managers
- Exco members
- EasyPay Group
- Call Centre
- Sales
- Team members
- Supervisor
- Managers
- Exco members
- EasyPay Group
- Call Centre
- Sales
05 May 2025;
from:
careers24.com