The Claims Administrator is responsible for providing efficient, accurate and customer-focused administrative support throughout the claims lifecycle. To act as the primary liaison between clients, the outsourced Claims Administrator (TPA), insurers, assessors and internal stakeholders, ensuring claims are progressed within agreed service levels while delivering an excellent customer experience. The role is responsible for monitoring claim progress, maintaining accurate records, resolving routine queries, coordinating communication and supporting compliance with insurer, regulatory and company requirements
Responsibilities
Claims Administration
Claims Validation & Documentation
TPA, Insurer & Service Provider Liaison
Client Communication & Customer Service
Claims Resolution
Client Retention
Referral Generation
Customer Feedback & Surveys
Query & Complaint Resolution
Compliance & Risk Management
Reporting & Administration
Required skills & competencies:
• Self-motivated with a consistently positive approach
• Dynamic individual who is able to multi-task
• Flexible (adapts easily to change)
• Ability to deal with staff on all levels
• Ability to establish, build, maintain and manage sound interpersonal relationships on both a verbal and written level (both internally & externally)
• Strong customer service orientation
• Able to work well in a team and/or individually
• Attention to detail and accuracy
• Commitment to Treating Customers Fairly (TCF) principles
Qualifications
Matric
FAIS and RE compliant (mandatory or advantageous
3 - 5 years short term insurance experience in Personal Line Claims is mandatory
Computer literate (Microsoft Office Suite)
Experience working on Cardinal C360 and insurance administration systems (advantageous)
