Full Job Description
THE JOB AT A GLANCE
As the Claims Administrator, you will report to the Team Leader: Claims Administrator. Your primary responsibilities will include capturing claims, following up on outstanding documents from relevant stakeholders, and indexing documents. Throughout the claims processing cycle, you will keep stakeholders informed and updated through various channels (email, telephone, SMS, etc.). Additionally, you will manage the day-to-day operations of the branch premises, handle queries from walk-in clients, and channel stakeholder inquiries according to the Service Level Agreement.
WHAT WILL YOU DO?
Claims Administration:
- Acknowledge claims upfront and differentiate between minor and serious injuries and products.
- Communicate and explain the claims process and requirements to claimants and employers as per predefined processes.
- Refer or channel claims to relevant departments.
- Gather information, and send follow-ups and reminders on outstanding claims documents.
- Prepare, scan, and index internal and external documents (e.g., medical reports, invoices, investigation reports, images) received from clients according to company procedures and the Service Level Agreement.
- Organize scanned documents on the local network.
- Identify and correct the legibility of scanned documents.
- Analyze documents received to produce appropriate shades and best resolution in scanned reproductions.
- Ensure there are no duplicate documents uploaded to the system.
- 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 inquiries.
- Identify and escalate priority issues.
- Act as backup for the Contact Centre for email/calls overflow and during system downtime.
Branch/Team Administration:
- Conduct all office planning regularly, as issues arise or in anticipation of needs.
- Continuously ensure proper housekeeping, safety, and security of the Rand Mutual Properties.
- Maintain records of office activities, including keeping 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. Respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions.
- Manage walk-in queries as 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 efficiently.
- Update existing customer personal information.
- Deal with all customers professionally and empathetically.
- Assist stakeholders with using the correct processes for logging their queries.
Reporting on Progress:
- Use appropriate templates and channels to report progress as and when required.
WHAT WILL YOU GET IN RETURN?
We offer great opportunities for personal and professional development in a stable company with a 130-year history. The role includes a competitive salary package and various benefits. You will be part of a dedicated group of colleagues who value teamwork and collaboration.
Turnaround Time
The shortlisting process will begin after the advert’s due date. The time taken to complete this process depends on your progress within the recruitment process and the availability of our managers. If you do not receive a response within 21 days, please consider your application unsuccessful.
Closing date: 17 July 2024
Our Commitment to Transformation
In line with Rand Mutual Assurance’s employment equity plan and goals, preference may be given to candidates from under-represented designated groups.
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 of clerical, scanning, and indexing experience.
- 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.
- Experience in insurance and/or medical aid.
- Knowledge of claims processing and approval.
