Job Description
Ensure proper flow of office procedures and supports the office operations by carrying out common administrative duties. Maintains a positive and friendly company image by acting as the first point of contact to visitors and clients.
Duties and Responsibilities
- To assess each claim on the system and identify the type of claim.
- Assess the validity of the identified claim by assuring all the supporting documentation has been submitted. assess the documentation in terms of signed claim form, id of deceased, proof of bank details, death certificate).
- Ensure valid claims are processed on the system and send for payment.
- For Claims that have outstanding documentation the successful candidate should ensure clients are notified of outstanding requirements.
- Invalid claims will be rejected/ repudiated.
- All claims processes must align to standard operating procedures (SOP).
- To maintain an error rating of less than 1%.
- Assure capturing of claims are done accurately.
- Assure all criteria is met to pay claim.
- Checking for possible fraudulent claims from existing claims set.
- Verifying and Adjudicating claims captured for correctness and compliance.
- Adjudicating claims manually flagged in the system at various levels.
- Attending to enquiries on benefits and products to members, prospective clients and service provides.
- Providing customers with accurate product and service information in an efficient manner.
- Dealing with all customers in a professional and empathetic manner.
- Communicating the claims process to both employer and clients as set out in the claim's management process.
- Preparing recommendations to reduce risk.
Qualifications and Experience
- Business Degree such as Risk Management & Insurance.
- Business Analytics.
- Research & Statistics.
- At least 1 year relevant experience in a similar environment essential.
- Proficiency on MS Word, & Excel (advanced level) essential.
- Must have a clean class 4 driver s Licence.
Competencies:
- Attention to detail.
- Customer focused.
- Investigative.
- Interpersonal skills.
- Analytical skills.
Other
How to Apply
Candidates meeting the above criteria should forward their Curriculum Vitaes (CVs) to the Human Resources via the following email address: zim@kingdombluefuneral.com and sichelesile.ndlovu@kingdombluefuneral.com
Deadline: 16 February 2024