Claims Consultant

7 days ago

Durban, South Africa Adzuna ZA B C2 Full time
  • Authorize claims within the set mandate and resolve all claims within the agreed productivity targets and turnaround times by utilizing the claims diary system effectively.
  • Apply and effectively communicate technical skills and resolve all technical issues using available tools and systems.
  • Demonstrate a clear understanding and execution of customer complaints and resolutions that must be maintained and exceeded, as well as a clear understanding of claim rejections.
  • Demonstrate a clear understanding of the management of claims handling that must be followed within the regulated agreements as specified by the relevant regulatory boards.
  • Ensure a clear understanding of all payments, the correct application of rates to be authorized to the service provider, and the correct appointment of service providers to the claims.
  • Ensure that all Customers are treated fairly, you must have a clear understanding and accurate interpretation of the reported incident, claims history, and correct application of the policy wording.
  • When communicating technical detail to the Customer, Loss Adjusters to consult or debate the outcome of the claim, ensure lateral thinking and professional engagement with all parties.
  • Have an inquisitive and investigative mind to communicate and report suspicious activity to the next reporting level if further intervention is required.
  • Possess the ability to communicate calmly and professionally yet assertively with difficult customers at all levels and outcomes in a fair, sensitive, and persuasive manner, always keeping in mind that the customer must be treated fairly as required.

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