Claims Fulfilment Specialist
4 days ago
A large and successful home loan and insurance provider requires a highly skilled Claims Fulfilment Specialist to join their team. The primary goal is to consistently exceed customer expectations while adhering to regulatory guidelines, ensuring timely settlement of claims through effective risk management principles.
Main Responsibilities- Authorize claims within set parameters, resolve all claims within agreed productivity targets and turnaround times using the claims diary system efficiently.
- Apply technical skills and communicate effectively to resolve technical issues utilizing available tools and systems.
- Maintain a clear understanding and execution of customer complaints and resolutions, as well as claim rejections, to ensure excellent customer service.
- Understand and follow regulated agreements specified by relevant regulatory boards for claims handling.
- Evaluate payments, apply correct rates to authorized service providers, and appoint service providers correctly for claims.
- Demonstrate thorough understanding of reports and quotes to provide prompt claims resolution to customers.
- Operate a claims management system, utilize relevant tools for quick claim resolution, and ensure effective communication, such as sending emails via Outlook and exporting reports to Excel.
- Familiarity with the internet and Google Maps usage.
Key Skills: Problem Solving, Effective Communication, Decision Making.
Responsibilities- Treat all customers fairly, maintaining a clear understanding and accurate interpretation of reported incidents, claims history, and policy wording application.
- Communicate technical details to customers and Loss Adjusters, ensuring lateral thinking and professional engagement with all parties.
- Employ an inquisitive and investigative mindset to report suspicious activity to the next level if further intervention is required.
- Ability to communicate calmly and professionally yet assertively with difficult customers at all levels and outcomes, treating customers fairly as required.
- Familiarity with engaging and communicating with specialist service providers, such as engineers.
- Maintain effective relationships with stakeholders within the organization, including:
Internal
- Finance Division to improve service delivery regarding payment authorizations.
- Home Loans Customer Contact Centre to assist and enhance customer communication, complaints, and technical support.
- Policy Administration for policy amendments, client queries/requests, and complaints resolution advice.
- Insurance Customer Contact Centre to provide assistance on noted anomalies or trends affecting new claims processing and identify associated risks.
- Management and peers to discuss contentious matters and report urgent claims requiring attention or authorization.
- Procurement Manager to ensure service providers adhere to the current service level agreement.
- Claims Fulfilment Manager for guidance, assistance, mentorship, and advice on growth and matters that can aid your development.
- Operations Manager for guidance, assistance, and advice on growth and other communications related to claims.
External
- Customer: Provide exceptional customer experience throughout the customer journey and assist in providing professional peace of mind when dealing with queries or feedback proactively.
- Panel or non-panel service providers: Ensure professional customer service interaction with loss adjusters, quantity surveyors, forensics experts, etc., and various specialists required for claim completion.
- Sales Representatives to resolve customer issues.
- Internal and external auditors for assistance during interim or final company audits.
- Pride in the company's mission, vision, and values must be taken seriously. Personal development and career path are crucial, following the company's code of ethics to improve reputation and brand.
- Compliance with organizations' and regulatory boards' regulations and legislation. Understanding, supporting, and living the organization's Amazing Service Culture is essential.
The ideal candidate should respond to technical aspects of policies and translate from reports accurately to respond to customers accordingly.
Required Experience & Qualification- Grade 12 qualification.
Preferred Qualification:
- Insurance-related qualifications, e.g. FETC: Short Term Insurance NQF 4, RE5.
- 4 years Claims experience, preferably Homeowners/Building Claims experience.
Preferred Experience:
- 5 years Short Term Claims Insurance-related experience, preferably with Homeowners/Building experience.
- Building/Homeowners Claims and Customer Service-oriented.
- Computer Literacy, Excel, Word, Microsoft Outlook.
- Claims Management and ability to navigate systems effectively.
- Understanding and communicating technical matters analytically.
- Excellent verbal and written communication skills.
-
Claims Fulfilment Consultant
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeClaims Fulfilment ConsultantA successful and large Homeloan and Insurance company requires the services of a Claims Fulfilment Consultant to join their team. The goal is to consistently exceed and practice customer expectations as governed by regulations on a regular basis and to drive timely settlement of claims whilst applying risk management principles at...
-
Fulfilment Claims Professional
7 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeAbout the RoleThis position involves authorizing claims, resolving technical issues, and demonstrating a clear understanding of customer complaints and resolutions. The consultant will work closely with stakeholders to ensure effective relations and promote consistent effective relationship building.Key responsibilities include processing claims,...
-
Claims Consultant Specialist
7 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeCompany OverviewS simply HR Payroll is seeking a skilled Claims Fulfilment Consultant to join their team. The ideal candidate will be responsible for consistently exceeding customer expectations, driving timely claim settlements, and applying risk management principles.The successful applicant will have a strong understanding of claims handling processes,...
-
Claims Specialist Position
4 days ago
Umhlanga, KwaZulu-Natal, South Africa The Appointment Firm Full timeClaims Specialist WantedThe Appointment Firm seeks a talented Claims Specialist to join our team in La Lucia Durban.About the PositionThis role involves working closely with clients to manage claims and develop effective solutions.Key ResponsibilitiesCommunicate effectively with clients and stakeholdersAnalyze claims data and develop insights for improved...
-
Claims Consultant La Lucia
7 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeClaims Fulfilment ConsultantA successful and large Homeloan and Insurance company requires the services of a Claims Fulfilment Consultant to join their team. The goal is to consistently exceed and practice customer expectations as governed by regulations on a regular basis and to drive timely settling of claims whilst applying risk management principles at...
-
Homeowner Claims Consultant
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeHomeowner Claims ConsultantA reputable home loan and insurance provider is seeking a skilled Homeowner Claims Consultant to excel in their team. The primary goal is to consistently deliver exceptional customer experiences while adhering to regulatory guidelines, ensuring timely settlement of claims through effective risk management practices.Main...
-
Insurance Claims Resolution Manager
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeInsurance Claims Resolution ManagerA leading home loan and insurance provider seeks an experienced Insurance Claims Resolution Manager to excel in their team. The primary objective is to consistently deliver exceptional customer experiences while adhering to regulatory guidelines, ensuring efficient claims resolution through effective risk management...
-
Short Term Claims Professional
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeShort Term Claims ProfessionalA leading home loan and insurance provider seeks an experienced Short Term Claims Professional to join their team. The primary objective is to consistently deliver exceptional customer experiences while adhering to regulatory guidelines, ensuring efficient claims resolution through effective risk management practices.Main...
-
Claims Management Specialist
1 day ago
Umhlanga, KwaZulu-Natal, South Africa Huntswood Full timeRole OverviewHuntswood requires a Claims Management Specialist to lead our team. The successful candidate will be responsible for managing a team of fraud analysts to achieve business performance objectives, KPIs, and SLAs.The role involves:Supervising a team of fraud analysts to achieve business performance objectives, KPIs, and SLAs.Providing technical...
-
Claims Consultant Specialist
4 days ago
Umhlanga, KwaZulu-Natal, South Africa The Appointment Firm Full timeClaims Consultant OpportunityAn exciting opportunity has arisen for a Claims Consultant at The Appointment Firm.Duties and Responsibilities:Claims Processing: Process claims in a timely and efficient manner.Problem Solving and Communication: Plan, communicate, solve problems, and carry out decisions effectively.Relationship Building: Practice and promote...
-
Claims Assessor: Life
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Pronel Personnel Full timeClaims Assessor (Life) - Job DescriptionOur client based in the Umhlanga area is seeking an experienced Claims Assessor (Life). The ideal candidate should have exceptional communication skills, work ethic, and dedication to the workplace.Requirements:Detailed knowledge relating to the specialist/technical nature of life claims assessmentGood understanding of...
-
Medical Claims Specialist
4 days ago
Umhlanga, KwaZulu-Natal, South Africa FEM Full timeFEM seeks a skilled Medical Claims Administrator to join our Durban branch in the Claims Department. The primary objective of this position is to efficiently assess and administer registered claims in accordance with the Compensation for Occupational Injuries and Diseases Act.The ideal candidate will possess functional computer literacy, strong literacy and...
-
Insurance Claims Specialist: Long Term
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Pronel Personnel Full timeAt Pronel Personnel, we are seeking an experienced Insurance Claims Specialist to join our team.The ideal candidate will have exceptional communication skills and a strong understanding of medical conditions and terminology.Job Requirements:Detailed knowledge of life claims assessment and insurance policiesAble to understand complex medical reports and...
-
Claims Assessor Life Specialist
4 days ago
Umhlanga, KwaZulu-Natal, South Africa Pronel Personnel Full timeAt Pronel Personnel, we are seeking an experienced Claims Assessor: Life to join our team. As a key member of our insurance services division, you will play a vital role in assessing life claims and ensuring that our clients receive the benefits they deserve.The ideal candidate should have exceptional communication skills, a strong work ethic, and a...
-
Home Loan Insurance Advisor
7 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeJob DescriptionWe are looking for an experienced Claims Fulfilment Consultant to join our team. The successful candidate will have a proven track record in claims handling, risk management, and customer service.The ideal candidate will possess excellent analytical and problem-solving skills, as well as strong communication and interpersonal skills.
-
Risk Management Associate
7 days ago
Umhlanga, KwaZulu-Natal, South Africa Simply HR Payroll Full timeResponsibilitiesThe Claims Fulfilment Consultant will be responsible for:Authorizing claims within set mandates and resolving claims within agreed productivity targets and turnaround times.Applying and communicating technical skills to resolve technical issues using available tools and systems.Demonstrating a clear understanding and execution of customer...
-
Vessel Management Specialist
7 days ago
Umhlanga, KwaZulu-Natal, South Africa University of Fort Hare Full timeOperations Leadership OpportunityWe are seeking a highly skilled National Operations Manager to join our team. As a key member of our organization, you will be responsible for driving operational excellence, ensuring seamless vessel and landside coordination, and maintaining strong relationships with key stakeholders.Your primary responsibilities will...
-
Claims Consultant
1 week ago
Umhlanga, South Africa Pro Stop Recruitment Services Full timeDisplay a clear understanding for effective Claims processing. - Demonstrate a clear understanding and execution of customer complaints and Resolutions, management of claims within the regulated agreements by regulatory boards - Can plan, communicate, solve problems, and carry out decisions effectively. - Have a clear understanding of how to engage and...
-
Consultant On Boarding
2 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeBring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job Summary To...
-
Investments Manager
1 week ago
Umhlanga, South Africa Absa Bank Limited Full timeEmpowering Africa’s tomorrow, together one story at a time. - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group. Job...
-
Specialist : Transactional Banker
2 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeBring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job...
-
Specialist - Working Capital Solutions
2 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeBring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job...
-
Learning and Development Co-ordinator
2 weeks ago
Umhlanga, South Africa F and G Sourcing Specialist Full timeOur **Retail Client** is seeking a **Retail Learning and Development Co-Ordinator** to join their team based in **Umhlanga, Durban.** **Purpose of the Job**: As the learning and development coordinator who thrives in a dynamic, fast-paced environment and has a strong training background, you will be responsible assessing the skill level of current...
-
Deceased Estate Administrator
3 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeBring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job Summary To...
-
Deceased Estate Administrator
3 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeEmpowering Africa’s tomorrow, together one story at a time. - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job Summary To...
-
Administrator Investment Absa Wealth Ops
3 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeEmpowering Africa’s tomorrow, together one story at a time. - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group. Job...
-
Regional Manager Caf Sme
2 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeBring your possibility to life! Define your career with us - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.Job Summary To...
-
Investigator Regional Fraud Risk
2 weeks ago
Umhlanga, South Africa Absa Bank Limited Full timeEmpowering Africa’s tomorrow, together one story at a time. - With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group. Job...
-
Human Resources Officer
7 days ago
Umhlanga, South Africa Marriott International, Inc Full time**Job Number** 22140149 **Job Category** Human Resources **Location** Protea Hotel Fire & Ice! Durban Umhlanga Ridge, 14 Palm Boulevard, Umhlanga Ridge, South Africa, South Africa VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Non-Management The HR Officer directs and works with Human Resources and...
-
Lead Generation/ Sales Trainer
1 week ago
Umhlanga Rocks, South Africa Icon AF Full time**1.JOB SUMMARY** The Lead Generation/ Sales Trainer at IconAF is **responsible for,** the **Quality of Training**conducted at the branches and for the trainees’ performance during live dialling and incubation phase. **2.Responsibilities & Duties** The responsibility of the Trainer is not exhaustive and may change from time to time as decided by...