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Quality Assessors
2 weeks ago
JOBNUMBER
iOCO03070
- CONTRACT TYPE
Contract
- STATE/PROVINCE
Gauteng
- CONTRACT TYPE
OnSite
The Role:
iOCO Infrastructure Services:
Where Challengers and Innovators Thrive.
We are looking to hire detail-orientated
Quality Assessors (Claims Assessors) x 7 who will be responsible for upholding and enhancing the quality of service delivery within the organization.
Skills and Experience:
What you'll do:
- Knowledge and understanding of how claims are handled and managed.
- Knows how to identify whether a policy is in force and the next steps in processing a claim notification.
- Knows which exclusions and policy conditions are standard and which are nonstandard. Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential nondisclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures.
- Identifies the most appropriate method of settling claims in line with organizational policies and procedures and in line with authority limits.
- Able to explain fraud and to list the main indicators including any particular to the classes of business being handled.
- Claims and Claims investigation with Research and Analytical.
Technical Competencies
- Customer Relationship Management, able to demonstrate concern for customer expectations and needs.
- Insurance Products and Service
Customer Advice (Technical)
- Claims Knowledge
- Reporting and Interpretation
- Research and Information Gathering
- Claims notification and Investigation
Claims notification and investigation
- Knowledge and understanding of the claims notification process
- Knows how claims notification information is used in the claims handling process for own area of business.
- Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential nondisclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures.
- Identifies, investigates, and resolves any issues relating to claims being handled in line with organisational policies and procedures. Identifies when a specialist needs to investigate a claim and follows organizational policies and procedures for appointing these.
Our expertise:
- 5 years' experience in an Insurance environment
Qualifications required:
- Grade 1
- Bachelor's Degrees and Advanced Diplomas
- Business, Commerce and Management Studies
- Claims Assessor Certificate (NQF4)
Other:
Insurance products and services
- Knowledge and understanding of the range of insurance products and services available in the market
- Skilled in identifying which types of insurance products and services are appropriate to a range of contexts/situations (e.g. critical illness cover, disability cover, income protection, funeral benefits and plans, life protection, medical cover, policy protection, annuity products, and shortterm insurance).
- Skilled in resolving insurance issues in the context of individual, family and/or business offerings. Demonstrates sound knowledge of competitors comparable products and services and their pricing.
Claims knowledge
- Knowledge and understanding of how claims are handled and managed
- Knows how to identify whether a policy is in force and the next steps in processing a claim notification.
- Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential non disclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures.
- Able to explain fraud and to list the main indicators including any particular to the classes of business being handled.
Other information applicable to the opportunity:
- Contract Position
- Location: Braamfontein, Johannesburg
- Work environment: Onsite
- Physical demands: Will be sitting the majority of the day doing administrative tasks
- Travel: Own vehicle essential
Why work for us?
If the daily grind makes you wonder if there's more to life than work, get ready to discover a professional journey that embraces excellenc
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