Claims Fulfillment Consultant

at  Pronel Personnel

A. CLAIMS PROCESSING

The following directly centers around your daily obligations:

• Authorise claims within the set mandate and resolve all claims within the agreed productivity targets and turnaround times by utilising the claims diary system effectively.
• Apply and effectively communicate technical skills and resolve all technical issues using available tools and systems.
• Demonstrate a clear understanding and execution of customer complaints and resolutions that must be maintained and exceeded, as well as a clear understanding of claim rejections.
• Demonstrate a clear understanding of the management of claims handling that must be followed within the regulated agreements as specified by the relevant regulatory boards.
• Ensure a clear understanding of all payments, the correct application of rates to be authorised to the service provider and the correct appointment of service providers to the claims.
• Demonstrate a thorough understanding of the report and quotes to communicate prompt claims resolution to the customer.
• Have a clear understanding of how to operate a claims management system, as well as the use of relevant tools that can enable the quick resolution of a claim and ensure effective communication, such as using Outlook to send emails, SMS and exporting own reports to Excel.
• Have a working knowledge of the internet and how to use Google Maps.

MINIMUM REQUIREMENTS:

• The candidate should respond on technical aspects of the policy and be able to translate from reports and respond accurately to the customers accordingly.

MINIMUM EDUCATION QUALIFICATION:

• Matric

PREFERRED QUALIFICATION:

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

MINIMUM EXPERIENCE:

• 4 years Claims experience, preferably Homeowners/Building Claims experience.

PREFERRED EXPERIENCE:

• 5 years Short Term Claims Insurance related experience, preferably with Homeowners/Building experience
  If you meet all of the above criteria, please apply directly here OR send your CV to recruit@pronel.co.za

We pride ourselves on our superior customer experience to all our customers, whether internal or external, by applying the highest technical claims knowledge and systems understanding when resolving claims and providing support. Our area of expertise consists of building claims. The inherent goal is to consistently exceed and practice customer expectations as governed by regulations on a regular basis and to drive timeous settling of claims, whilst applying risk management principles at a consultant level.