Claims Consultant

Company:Telesure Group Services
Reference #:Claims Consultant
Salary:Market Related
Location:South Africa

Introduction
The Claims Consultant contributes to the organisational goals by capturing, validating and administering claims to ensure efficient and accurate claims processing and costing, while delivering excellent service to the customer


Job Functions:Operations

Industries:Insurance

Specification

•Ensure capturing of detailed, accurate information
•Ensure correct information is obtained from the customer - by asking the appropriate questions and listening - to make correct decisions
•Use appropriate tools (My Market, supplier contact and / or negotiation) to accurately cost the claim, and make informed and appropriate decision which is correct for the business and reasonable for the customer
•Remain up to date (have good general knowledge of) with insurable goods, and knowing where to find appropriate information
•Ensure claims are finalised with set parameters (turnaround time, terms and conditions applied accurately)
•Ensure regular feedback to customers and other stakeholders, as determined by the company and/ or customer requirements
•Building and maintaining relationships, and liaising with, key stakeholders (e.g. Assessing, In-Touch, Legal, suppliers etc) to meet job objectives
•Taking accountability for full resolution of claims processes (incl. the communication of the outcome of the claim), to deliver a quality service to, and retain, customers
•Take accountability forthe resolution of customer complaints, with a view to customer retention
•Be innovative and use judgement to solve unique or unusual customer situations outside set parameters, with a view to customer retention.
•Deliver the Telesure Service Way through personal effort and through others.
•Deliver on Treating Customers Fairly principles in alignment with regulatory requirements.


Requirements
Collecting Information:
•Noting unusual occurrences.
•Asking questions to establish information required.
•Establishing information for proof, validation or evidence.
•Inquiring into claims or disputes.
•Listening to arguments or evidence.
•Scanning written information for useful content.
•Searching literature or other data sources.

Analysing / Integrating / Interpreting:
•Summarising verbal information.
•Analysing written information.
•Interpreting information (e.g. to simplify or explain).
•Interpreting rules, laws, agreements, etc.
•Evaluating alternatives prior to choice.
•Critically examining information for accuracy / quality.

Deciding:
•Making decisions after thorough evaluation.
•Deciding a price to quote to a customer.
•Deciding a course of action on own initiative.

Influencing / Presenting / Briefing:
•Advising on everyday points of procedure.
•Making a spoken case for a course of action.
•Negotiating on points of dispute.

Public Relations / Developing Relationships:
•Advising members of the general public.
•Responding to complaints.
•Working well with others in team or unit.
•Maintaining good public relations.
•Establishing relationships with antagonistic individuals.
•Establishing rapid rapport with a new contact.

Competency Requirements:

Knowledge Requirements:

Formal Qualifications:
Level of Education:
•Essential: Grade 12 (Standard 10)
•FAIS Accreditation

Experience:
•1-3 years Financial / insurance / call-centre experience.
• Claims experience is desirable.
• Commercial insurance experience is desirable.

Knowledge of:
•Insurance Industry.
•Customer service.
•Internet (google, search engines etc.).
•Systems (Capturing and storing information, database orientated etc.) (desirable).
•MS Windows and Microsoft Office (Excel, Outlook, Word etc.).
•Vehicle and Motor industry (What happens when you brake on a wet road).

Skills:
•Customer service orientated.
•PC Literacy.
•Communication (Verbal and Written).
•Time Management.
•Conflict Management.
•Organised and ability to prioritise.
•Analytical thinker.
•Investigative skill.
•Initiative, ability to problem solve.
•Decisive.
•Telephone etiquette.

Skill Requirements

Leading and Deciding:
Deciding and Initiating Action:
•Takes responsibility for actions.
•Projects and people.
•Takes initiative and works under own direction.
•Initiates and generates activity and introduces changes into work processes.
•Makes quick, clear decisions which may include tough choices or considered risks.

Interacting and Presenting

Relating and Networking:
•Easily establishes good relationships with customers and staff.
•Relates well to people at all levels.
•Builds wide and effective networks of contacts.
•Uses humour appropriately to bring warmth to relationships with others.

Persuading and Influencing
•Gains clear agreement and commitment from others by persuading, convincing and negotiating.
•Makes effective use of political processes to influence and persuade others; promotes ideas on behalf of oneself or others.
•Makes a strong personal impact on others; takes care to manage one’s impression on others.

Presenting and Communicating Information
•Speaks fluently.
•Expresses opinions, information and key points of an argument clearly.
•Makes presentations and undertakes public speaking with skill and confidence.
•Responds quickly to the needs of an audience and to their reactions and feedback.
•Projects credibility.

Analysing and Interpreting

Analysing:
•Analyses numerical data and all other sources of information, to break them into component parts, patterns and relationships.
•Probes for further information or greater understanding of a problem.
•Makes rational judgements from the available information and analysis.
•Demonstrates an understanding of how one issue may be a part of a much larger system.

Creating and Conceptualising:

Learning and Researching
•Rapidly learns new tasks and commits information to memory quickly.
•Demonstrates an immediate understanding of newly presented information.
•Gathers comprehensive information to support decision making.
•Encourages an organisational learning approach (i.e. learns from successes and failures and seeks staff and customer feedback).

The Telesure Service Way Requirements

Make it Easy to Connect:
•Listens attentively (does not interrupt) to understand emotional state and b) customer’s need.
•Asks clarifying questions to ensure need is clearly understood.
•Calmly accepts constructive feedback (remains calm and engaged).
•Responds appropriately to cues on type of customer and emotional state.

Make it Easy to Understand:
•Explains compliance requirements, policy and / or services clearly and in logical steps.
•Requests upfront all information necessary in order to solve the customer need / problem.
•Explains why additional information may be required.
•Shares the reasons behind information needs and / or policy and service structures.

Make it Easy to be Kept Informed:
•Explains the steps in the process clearly – what will happen, what must the client do / expect.
•Confirms with the customer when and how feedback would typically be given.
•Agrees time and method of feedback that is convenient for customer.
•Follows through on giving feedback in the manner agreed.
•Proactively provides information so as to avoid unnecessary comebacks.
•Explains clearly the reason why, if a customer is to be put on hold / transferred.

Make it Easy to Consider It Done:
•Honours commitments to others.
•Meets important goals and deadlines.
•Takes responsibility for own mistakes and correcting them.

Job Closing Date:15/08/2018


Apply Here http://bit.ly/2MmUdBF

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