Payment Consultant MMH251204-10

Role Purpose

To process accurate and timeous payments of various claim types to ensure an effective client experience.

Requirements

• Matric
• Relevant Financial degree or diploma
• 1-2 years' experience in life insurance claims would be beneficial
• Relevant insurance knowledge, applicable regulatory requirements and legislations would be beneficial

Duties and Responsibilities

Audit and authorise claims within insurance policy guidelines (Internal Business Process)

• Processing claims payments timeously whilst capturing the information on the Claims system across Critical Illness, Income Protection, Disability and Death benefits product lines
• Manage and maintain workflow and service level standards to ensure delivery of timeous and consistent claim payments to clients.
• Ensure the correct client and benefit details are assessed before processing any payment to ensure accuracy.
• Ensure all payment required documentation and payment summaries are received in order to make payment, e.g. tax directive, bank confirmation, world check.
• Liaise and resolve with assessors and consultants on payment process should there be any discrepancies
• Monitor payment queues and personal queues to ensure that work is distributed and attended to within agreed SLAs.
• Management of long term claims
• Confirm payment processed via relevant communication to provide client an optimal client journey.
• Responsible for all payment escalations through investigating, supporting and communicating to all stakeholders involved (client, the assessors, escalations team and claims consultants).
• Assist with the development and execution of the payment process methodology across all payment types.
• Monitor the application of the payments process and methodology through current best industry and company practices and technological enablers to ensure successful execution a client's claim.
• Familiar with the regulatory framework, insurance related practices by regulatory bodies, governing bodies etc. that could impact the way claims are processed and paid.
• Embed and apply claims payment tools that allow for more efficient processing and risk management capabilities
• Assist with the review of the payment process and related documentation to ensure that our risk management standards are met
• Incorporate internal feedback into the enhancement of daily business processes and management operating systems

Engage with clients in a client centric manner (Client Services)

• Provide factual, logical, expertise and advice to clients and stakeholders within area of responsibility (product, service and payment).
• Build and maintain relationships with clients, internal and external stakeholders
• Deal promptly with all client/broker requests in a competent, efficient and professional manner to ensure client retention and satisfaction
• Deliver on service level agreements with all stakeholders to ensure that client expectations are met and managed
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service

Self-management and teamwork (People)

• Develop and maintain productive and collaborative working relationships with peers, team members and stakeholders
• Adhere to policies, procedures and take corrective actions where necessary
• Positively influence and participate in change initiatives.
• Continuously develop own expertise in terms of professional, industry and legislation knowledge
• Contribute to continuous innovation through the development, sharing and implementation of new ideas to enable the claims function
• Take ownership for driving career development

Contribute to financial controls and planning (Finance)

• Responsible to manage, identify and mitigate risk through the adherence of the claims process
• Identify to enhance cost effectiveness and increase operational efficiency within the claims payment environment.
• Manage financial and other company resources under your control with due respect
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

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