THE JOB AT A GLANCE As the Claims Administrator, you will be reporting to the Team Leader: Claims Administrator. You will be responsible for capturing of claims, following up on outstanding documents from relevant stakeholders and indexing of documents. You 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. In addition, you will also be responsible for the day-to-day operations of the branch premises where applicable, manage queries from walk-in clients and channel stakeholder queries according to the Service Level Agreement. WHAT WILL YOU DO? Claims Administration:
Acknowledgement of 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 / 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. 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 Employer
Perform any other ad hoc duties as assigned
Provide backup services for team members
Capture Temporary Total Disablement for payment.
Query resolution:
Manage and resolve customer enquiries
Identify and escalate priority issues
Act as backup for the Contact Centre for emailcalls overflow and during system downtime.
Branch / Team Administration:
Carry out all office planning on a regular basis, as issues arise, or in advance of anticipated needs
Continuously ensure proper housekeeping, safety and security of the Rand Mutual Properties
Compiling records of office activities i.e. keep an electronic and manual register of walk in clients
Order and maintain relevant office supplies
Arrange team meetings and distribute minutes.
Customer Service:
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 in line with the RMA Service Catalogue
Handle customer inquiries both telephonically and by email
Research required information using available resources
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.
Reporting on progress:
Using appropriate templates and channels to report progress as and when required. WHAT YOU'LL BRING TO THE TABLE?
NQF Level 5 Higher Certificates and Advanced National (vocational) Certificate in business administration or commerce
2-3 years clerical, scanning and indexing experience required
Data-entry experience and good typing skills
Additional insurance related qualifications or training will be advantageous
Knowledge of administrative and clerical procedures
Computer literate - Intermediate MS Office Suite
Knowledge of customer service principles and practice
Good Administrative skills
Deadline driven
Additional insurance related qualifications or training will be advantageous
Insurance and/or Medical Aid experience
Knowledge of Claims processing, approval.
WHAT WILL YOU GET IN RETURN? We offer great opportunities for personal and professional development in a stable company thats 128 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration. Turnaround time The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. Kindly note that should you not receive a response within 21 days please consider your application unsuccessful. Closing date: 28 February 2024 Our Commitment to transformation: In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets, preference may be given, but is not limited, to candidates from under-represented designated groups.
NQF Level 5 Higher Certificates and Advanced National (vocational) Certificate in business administration or commerce
2-3 years clerical, scanning and indexing experience required
Data-entry experience and good typing skills
Additional insurance related qualifications or training will be advantageous
Knowledge of administrative and clerical procedures
Computer literate - Intermediate MS Office Suite
Knowledge of customer service principles and practice
Good Administrative skills
Deadline driven
Additional insurance related qualifications or training will be advantageous
Insurance and/or Medical Aid experience
Knowledge of Claims processing, approval.
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