Desktop Merit Assessor (JG9)

at  Sanlam

CAREER OPPORTUNITY

Santam Direct Claims department has a position available for a Desktop Merit Motor assessor who will bebased in Tygervalley, Cape town.

JOB DESCRIPTION

The desktop assessor is accountable for all motor claim interactions directly with the client. Processing of alldirect merit claims administration including co-ordinating and overseeing all actions on claims in this channel.The assessor would also need to identify problematic claims (red flags) and have it sent for further validationby one of the field teams. The outcome of each claim should be communicated to the client within the agreed SLA.

QUALIFICATIONS AND EXPERIENCE

• Matric certificate or equivalent qualification
• Insurance related qualification
• Computer literate (MS Word, MS Excel and MS Power Point)
• Experience in high volume processes management (advantageous)
• 2 - 3 years’ experience in short term claims environment with focus on Personal Lines

SKILLS

• Experience in high volume processes management (advantageous)
• Knowledge of quality processes
• Computer Literate (MS Office Package)
• Proficient in English
• Excellent communication (verbal & written )
• Negotiation skills
• Ability to work under pressure
• Strong client service orientation
• Good knowledge and interpretation of insurance contracts

• Receive claim and facilitate resolution – responsible for the merit process.
• Handling of client queries to limit client complaints.
• Manage all relevant and expected communication to internal stakeholders within the agreed SLA
• Ensure that claims are finalized within agreed SLA
• Determine merit, investigation and determine whether external service providers are required as per SOP.
• Assess claims by reviewing field reports and/or digital images or document received.
• Proactive identification of fraudulent cases and recovery potential.
• Interaction with the Police, Witness and Third Parties etc. to validate merits.
• Understands legal liability considerations in given claims.
• Decide on settlement recommendation.
• Liaise with internal stakeholders, e.g. Underwriting, Claims Committee, Claims Technical, Assessing and Legalfor Policy interpretation issues.
• Pro-actively manage client expectation and ensure that all communication to client’s are completed within therequired SLA