Claims Consultant: Business Insurance: Jhb

**ABOUT THE COMPANY**

TIH is the holding company of some of South Africa’s leading financial service providers. Our portfolio includes short-term insurers, a long-term insurer, health insurance as well as an insurance and personal finance comparison platform. We’re pioneers with a hunger for best, bringing customer-focused innovation and service excellence to the financial services industry. We’re an undivided team of diverse thinkers and doers who believe in leading through technology and

pushing past their limits.

**JOB PURPOSE**

Obtain information from insured or designated persons for the purpose of validating claims using all resources available.

**RESPONSIBILITIES**

**Client & Customer Management (External)**

Help manage clients by carrying out standard activities and providing support to others.

**Data Collection and Analysis**

Produce accurate reports for others by collecting data from a variety of standard sources and inputting it into standard formats.

**Work Scheduling and Allocation**

Organise own work schedule in order to get the job done, coordinating with support services and assigning short-term tasks to others if necessary.

**Administration**

Produce, update and provide best practice support on MS documents, databases and other departmental systems to support the work of more senior colleagues. Tasks could include purchasing materials, entering budgetary information, time and expense recording and similar.

**Correspondence**

**Document Management**

Create, organise, and maintain files containing the correspondence and records of a senior colleague.

**Document Preparation**

Prepare routine letters, memoranda, reports and similar documents following detailed instruction. This is likely to involve using the full range of functions within standard office software.

**TASKS**

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- Prepare insurance claim forms or related documents and review them for completeness.
- Enter claims information into database systems.
- Validation of high quantum claims (Motor and Non-Motor)
- Calculate amount of claim.
- Post or attach information to claim file.
- Transmit claims for further investigation.
- Contact insured or other involved persons to obtain missing information.
- Review insurance policy to determine coverage.
- Organize or work with detailed office records, using computers to enter, access, search or retrieve data.
- Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.

**BEHAVIORAL COMPETENCIES**

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**Decision Quality**

Makes good and timely decisions that keep the organization moving forward. For example, knows when to act independently and when to escalate issues. Integrates various inputs, decision criteria, and trade-offs to make effective decisions. Typically makes good independent decisions.

**Manages Complexity**

Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. For example, looks at complex issues from multiple angles; explores issues to uncover underlying issues and root causes; sees the main consequences and implications of different options.

**Customer Focus**

Builds strong customer relationships and delivers customer-centric solutions. For example, probes deeply into customer needs to identify less obvious interests or expectations. Consistently goes above and beyond to understand customer requirements and surpass their expectations.

**Drives Results**

Consistently achieves results, even under tough circumstances. For example, devotes considerable effort to surpassing goals and achieving the best possible results; goes above and beyond to achieve excellence. Drives ahead with great focus when faced with obstacles and setbacks; maintains productivity and a positive attitude.

**Being Resilient**

Rebounds from setbacks and adversity when facing difficult situations. For example, is calm and professional in difficult situations; continues to work toward objectives. Overcomes obstacles without becoming discouraged; draws lessons from failures. Recovers from setbacks and adversity.

**Manages Conflict**

Handles conflict situations effectively, with a minimum of noise. For example, disagrees with others in a respectful and tactful manner; handles conflicts and differences of opinion in a calm, composed manner; rebounds from conflicts without animosity.

**Communicates Effectively**

Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences. For example, listens attentively and takes an interest. Keeps others well informed; conveys information clearly, concisely, and professionally when speaking or writing.

**Ensures Accountability**

Holds self and others accountable to meet commitments. For example, accepts responsibility for own work, both successes and failures. Handles fair share and does not make excuses for problems. Usually meets com