Insurance Merit Consultant
4 days ago
This role requires the ability to verify and interpret policy and appraisal detail, be able to think on your feet, and have basic computer skills (MS Office).
Familiarity with Santam systems is also required.
The ideal candidate will have sound understanding of policy wordings and application thereof, as well as investigative abilities to identify red flag claims.
Key Responsibilities- Manage workload and complete claims within SLA.
- Validate claims from the desk.
- Listen to relevant recordings, sales/claims/SOS.
- Complete merit report with all findings.
- Conduct assessments with clients, interview authorities & witnesses.
- Deal with Underwriters and Claims technical.
- Handle complaints, queries and all interactions with clients, Intermediaries, Service Providers, internal stakeholders, Relationship Managers.
- Present claims in claims committee.
- Make notes on systems, process claims and upload documents.
- Compile rejection letters and distribute them to relevant stakeholders.
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