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Claims Executive

To register, administrate, negotiate and finalize claims with emphasis on managing the average claims cost and providing exceptional service to the clients on your portfolio in achieving the department’s targets for a profitable loss ratio.

 

Required Competencies

  • RE 5 completed
  • 3 Years claims experience
  • Full FAIS Qualification or working towards obtaining it

 

Deliverable Performance standard Performance indicator

  1. Registered Claims
  • Register all claims accurately and correctly with all relevant information captured on the system
  • Manage all Statuses on claims – statuses to be updated and correct at all times
  1. Suppliers/ assessors/ loss adjustors appointed
  • Appoint all Suppliers/ Assessors/ Loss adjustors timeously and accurately and ensure that the Suppliers/ Loss Adjustors and Assessors give feedback in accordance to agreed SLA’s
  1. Repair/ replacement authorizations
  • Authorize repairs / replacements at the most cost effective Insurer approved suppliers that can assist the client in the shortest possible turnaround time.
  • Request & calculate claim settlements accurately as per set internal claims processes
  1. Service
  • Finalize claims within set internal Claims SOP
  • Ensure that all client interactions, telephone calls are according to Quality Assurance standards
  • Ensure that all calls are answered within the agreed SLA
  • Effectively manage and escalate deviations on claims as per set internal processes
  1. Feedback
  • Give timeous and accurate feedback to clients according to set internal Claims SLA

 

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