Claims Operations Specialist

5 days ago


Pretoria, Gauteng, South Africa Digicall Group Full time

Role Overview

Digicall Group is seeking a skilled Claims Operations Specialist to manage the claims function within the short-term assessment field. This role requires effective administration and addressing customer needs by providing information, resolving queries, and handling requests.

Responsibilities

  • Monitor service level agreements (SLAs) with contractors to ensure timely completion of repairs.
  • Address delays by following up with contractors and escalating non-compliance where necessary.
  • Track the progress of ongoing repairs and ensure timely completion.
  • Obtain clearance certificates confirming that work has been completed to the required standard.
  • Verify and process final invoices from contractors, ensuring accuracy and compliance with agreed terms.
  • Ensure timely submission of assessor reports for claims assessment.
  • Cross-check reports for completeness and escalate discrepancies or delays.
  • Liaise with assessors to clarify findings and ensure alignment with claim requirements.
  • Keep clients informed on the status of their claims at key stages of the process.
  • Provide updates on approvals, repairs, and settlement timelines.
  • Address customer queries professionally and promptly.

Qualifications

  • Grade 12 or equivalent NQF level 4 qualification.
  • Minimum of 1 year non-motor claim experience.

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