Life Claims Administrator

About the role

As the Claims Administrator, you will report to the Claims Manager: Life. You will capture claims, follow up on outstanding documents from relevant stakeholders, and index documents. You will keep stakeholders informed and updated via email, telephone, SMS, etc., throughout the claims processing cycle. You will also manage day-to-day operations of the branch premises where applicable, handle walk-in client queries, and channel stakeholder queries according to the Service Level Agreement.

Responsibilities

• Claims Administration:
  • Acknowledge claims upfront
  • Communicate and articulate the claims process and requirements to claimants and brokers per predefined processes
  • Refer/channel claims to relevant departments
  • Gather information, send follow-ups and reminders on outstanding claims documents
  • Prepare, scan, and index internal and external documents (e.g., medical reports, invoices, investigation reports, images) according to company procedures and Service Level Agreement
  • Organise scanned documents on the local network
  • Identify and edit/correct the legibility of scanned documents
  • Analyse documents to produce appropriate shades and best resolution in scanned reproductions
  • Ensure no duplicate documents are uploaded on the system on an ongoing basis
  • Perform ad hoc duties as assigned
  • Provide backup services for team members
  • Perform claims registration and relevant verifications
• Query resolution:
  • Manage and resolve customer enquiries
  • Identify and escalate priority issues
• Team Administration:
  • Compile records of office activities (e.g., keep an electronic and manual register of walk-in clients)
  • Order and maintain relevant office supplies
  • Arrange team meetings and distribute minutes
  • Manage the central mailbox
  • Allocate work and channel work and queries accordingly
• Customer Service:
  • Regularly communicate and liaise verbally and in writing with customers, suppliers, visitors, enquirers, and relevant staff; interpret and respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions
  • Handle walk-in queries as required in line with the RMA Service Catalogue
  • Handle customer inquiries both telephonically and by email
  • Research required information using available resources
  • Provide customers with accurate product and service information efficiently
  • Update existing customer personal information
  • Deal with all customers in a professional and empathetic manner
  • Assist stakeholders with using the correct processes for logging their queries
• Reporting on progress:
  • Use appropriate templates and channels to report progress as and when required

Requirements

• Grade 12 qualification / Matric Certificate
• NQF Level 5 Higher Certificate or Advanced National (vocational) Certificate in business administration or commerce
• 2–3 years clerical, scanning, and indexing experience
• Data-entry experience and good typing skills
• Additional insurance-related qualifications or training advantageous
• Knowledge of administrative and clerical procedures
• Computer literate – Intermediate MS Office Suite
• Knowledge of customer service principles and practice
• Good administrative skills
• Deadline-driven
• Insurance and/or Medical Aid experience
• Knowledge of claims processing and approval