Claims Fulfilment Consultant

**Key Purpose**

**Key Responsibilities**

Display a clear understanding for effective Claims processing

Authorize all claims within set mandate and resolve all claims within agreed productivity targets and turnaround times, through the effective use of the claims diary system.

Display a clear understanding and execution of customer complaints and resolution that need to be maintained and exceeded, together with a clear understanding of rejections of claims.

Display clear understanding of management of claims handling that need to be adhered to within the regulated agreements as set for by the relevant regulatory boards.

Have the understanding of the internet and how to use google maps.

Have the ability to effectively plan, communicate, solve problems, and execute decision making

Ensure lateral thinking in claims handling and professional engagement with all parties when communicating technical detail to the customer, Loss Adjusters in order to consult or debate outcome of the claim.

Have an enquiring and investigative mind to communicate and report suspicious activity to next reporting level should this require further intervention.

Possess the ability to communicate in a calm yet assertive manner with difficult customers across all levels and outcomes in a fair, sensitive and persuasive manner whilst always keeping in mind to ensure that the customer has been treated fairly as regulated.

Have the clear understanding to engage and communicate with the appropriate specialist service providers to engage on each claim, if necessary, such as engineers, etc.

Practice and consistently promote effective relationship building

You are responsible to ensure that you maintain effective relations with all stakeholders within the organization. This includes but is not limited to:
Internal

Daily relationships with:

- Finance Division to improve on service delivery issues regarding payment authorizations
- SA Home Loans Customer Contact Centre to assist and improve customer communication, complaints, and technical support
- Policy Administration for advice of any policy amendments, client queries/requests, and complaints resolution
- SAHL Insurance Customer Contact Centre to provide and assist with advice on any noted anomalies or trends that could affect the processing of new claims and identify risks associated if any
- Management and peers to provide daily interactions about any contentious matters and or report on urgent claims that require attention or authorization
- Procurement Manager, to ensure that service providers strictly adhere to the current service level agreement
- Claims Fulfillment Manager, to guide, assist and advice you of all matters that can assist you with your growth. Communication will also be provided by your first line report in terms of urgent claims that require attention or authorisation
- Operations Manager, to guide, assist and advice you through your first line report, in line with your growth and any other communication in terms of your claims

External

Daily relationships with:

- SA Home Loans Customer to provide exceptional customer experience throughout the customer journey with the customer and to assist them professional peace of mind while dealing with queries or providing feedback proactively
- Panel or non-panel service providers ensuring professional customer service interaction, with loss adjusters, quantity surveyors, forensics experts, etc. and various specialists required to complete the successful outcome of a claim
- SA Home Loans representatives to provide assistance and resolve customer issues
- Internal and external auditors to provide assistance during interim or final company audits

Values and self-development

It is of utmost importance that pride is taken in terms of the company mission, vision and values. It is important that you take responsibility for your own personal development and career pathing. You must abide and adhere to the company code of ethics, by doing so you enhance the reputation and brand of yourself, your department and your company. You must comply and adhere to regulations and legislation governed by the organization and regulatory boards. You are required to understand, support and live the Amazing Service Culture of the organization. You are to carry out instructions that are fair and reasonable, that is given to you, within the prescribed turnaround time, whether written or verbal, as noted in the operational manual, regulatory boards, operating procedures and processes, to ensure that we achieve only the best outcome for and in the interest of the customer and the business.

Minimum Requirements:
Required Language: Afrikaans

Minimum Education Qualification:
Matric

Preferred Qualification:
Insurance related qualifications e.g. FETC: Short Term Insurance NQF 4, RE5

Minimum Experience:
4 years Short Term insurance related experience, preferable Homeowners Claims assessment experience

Preferred Experience:
5 years Short Ter