Contents Claims Administrator – Digicall

ROLE SUMMARY

Responsible for effectively managing the claims function within the short-term assessment field, ensuring successful administration and addressing customers’ needs by providing information, resolving queries, and handling requests.

QUALIFICATIONS

• Grade 12 or equivalent NQF level 4

EXPERIENCE

• Minimum of 1 year non motor claim experience

SKILLS & KNOWLEDGE

• Computer proficiency to work effectively with certain assessment tools or software e.g., in-house systems.
• Good verbal and written communication skills (English).
• Working knowledge of claims processes and procedures.

RESPONSIBILITIES

OPERATIONAL

• Monitor service level agreements (SLAs) with contractors to ensure timely completion of repairs.
• Address delays by following up with contractors and escalating non-compliance where necessary.
• Track the progress of ongoing repairs and ensure timely completion.
• Obtain clearance certificates confirming that work has been completed to the required standard.
• Verify and process final invoices from contractors, ensuring accuracy and compliance with agreed terms.
• Ensure timely submission of assessor reports for claims assessment.
• Cross-check reports for completeness and escalate discrepancies or delays.
• Liaise with assessors to clarify findings and ensure alignment with claim requirements.
• Keep clients informed on the status of their claims at key stages of the process.
• Provide updates on approvals, repairs, and settlement timelines.
• Address customer queries professionally and promptly.
• Accurately capture and update claim details on the insurer’s claims management system.
• Ensure all claim records are well-documented and easily accessible for reference.
• Identify potential risks and escalate suspicious claims to the Line Manager for further investigation.
• Work closely with and support internal teams such as Assessors on claims.
• Review claim submissions to verify all required documents are complete and accurate.
• Follow up with clients or third parties for missing or additional documentation.

COMPETENCIES

• Examining Information: Analyses and processes information; asks probing questions; strives to find solutions to problems.
• Documenting Facts: Writes fluently when documenting facts; understands arguments logically; focuses on finding facts.
• Interacting with People: Is lively and projects enthusiasm; is talkative in making contact; is focused on interacting and networking with people.
• Showing Composure: Stays calm and relaxed during events; is not worried and tolerates stress levels; is composed in dealing with pressure.
• Team Working: Works participatively with others; is democratic and encourages team contributions; collaboratively involves others in decision-making.
• Checking Things: Is meticulous in finding errors; ensures accuracy by being thorough and checking details; produces high quality work by being detailed.
• Following Procedures: Conforms and adheres to rules; closely follows instructions and procedures; minimizes risks by sticking to processes.
• Meeting Timescales: Is target focused and meets deadlines; is punctual and keeps to schedule; is reliable in finishing tasks.
• Upholding Standards: Behaves ethically and justly; is discreet and maintains confidentiality; meets commitments by acting with integrity.
• Managing Tasks: Manages tasks by being organized and methodical; plans activities systematically; sets priorities for tasks.