Processing and paying valid funeral claims and managing risk by identifying
Produce, update and provide best practice support to customers on the claims
administration process and other departmental systems, in line with claims
policy, rules and SLAs.
Customer Management (Internal)
Help manage customer by carrying out standard activities to complete the
Liaise with complaints department on customer complaints and queries
regarding outcome of claims decision.
Adhere to SLAs between the claims and the complaints department.
Provide the complaints department with comprehensive feedback on the
background of the claim and decision made.
Respond to routine requests using telephonic conversation or emails (internal
Ensure that a claimant is kept informed at all times with regards to their claim
Data Collection & Analysis
Ask questions, collect data from a variety of sources, analyse information and
Ensure that a client policy is valid through the appropriate due diligence (such
as listening to the policy sales/retention etc. phone conversation).
Ensure that relevant waiting periods have expired and that all premiums have
been received on the policy
Appropriately escalate any red flags / discrepancies to the relevant department
(for example forensics) as and when identified.
Ensure that the correct decision is made with regards to acceptance/declining
payment of a claim based on appropriate documents received and relevant
contracts in place.
Create, organize and maintain files containing the correspondence relating to
policies and matters.
Ensure that all appropriate documents are in place relating to a client policy.
Prepare and manage claim documentation for customers.
Ensure that the appropriate settlement documentation is sent to the appropriate
parties outlining the amounts paid and the reasons for it.
Ensure that the relevant parties for a declined claim are contacted and the
reasons for the claim being declined is explained thoroughly.
Work Scheduling and operational compliance
Organize own work schedule in order to get the job done, coordinating with
support services and complete work within SLA.