Telesure Investment Holdings: Funeral Claims Assessor

Company Telesure Investment Holdings
Reference # FCA2020
Published 29/10/2020
Contract Type Permanent
Salary Market Related
Location Dainfern, Gauteng, South Africa
Introduction
Telesure Investment Holdings (Pty) Ltd (TIH), is the holding company of some of
South Africa’s leading financial long and short term insurance providers. Our
portfolio includes South Africa’s most loved and recognisable brands such as 1st
for Women, Auto & General, Budget, Dial Direct, Virseker and 1Life. Employee
Benefits Administration via our Hippo Advisory Services, which includes health
insurance, provident fund and group life administration. Hippo is South Africa’s
first comparison website and compares insurance, other personal finance
products, travel, health, money, travel, cars from a range of South African
brands. We’re pioneers with a hunger for the best, bringing customer-focused
innovation and service excellence to the financial services industry. We’re an
undivided team of diverse thinkers and doers who believe in leading through
technology and pushing beyond limits.
Job Functions Administration,Call Centre,Compliance & Regulatory Affairs,Data Management
Industries Insurance
Specification
Purpose:
Processing and paying valid funeral claims and managing risk by identifying
fraudulent claims.

Responsibility:
Administration
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
customer request.
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.

Correspondence
Respond to routine requests using telephonic conversation or emails (internal
and external).
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
investigate claim.
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.

Document Management
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.

Document Preparation
Prepare and manage claim documentation for customers.
process.
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.

Requirements
Education

Grade 12/ SAQA Accredited Equivalent (Essential); Recognized FSCA
Qualification (Essential); Regulatory Exam 5 (Essential); Class of Business
Certification (Advantageous)

Experience
1-2 years funeral claims assessing experience in the funeral insurance industry

Job Closing Date 12/11/2020

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