Claims Administrator

The Claims Administrator is responsible for managing, processing, and finalizing customer claims in accordance with company policies, service-level agreements (SLAs), and regulatory requirements. The role ensures accurate documentation, timely communication, and effective resolution of claims while delivering exceptional customer service and maintaining data integrity.

Key Performance Areas:

1. Daily activities:

• Receive, review, and register new claims on the system
• Validate all claim documentation for completeness and accuracy
• Process and Assess claims in line with company guidelines and policy terms
• Maintain accurate and up-to-date records of all claim activities on clients Einstein profile
• Resolve queries efficiently and maintain a high standard of service delivery

2. Customer Service & Stakeholder Communication:

• Contribute to process improvement initiatives to enhance customer experience
• Communicate claim outcomes, requirements, and updates to customers timeously
• Engage with internal departments (Finance, Legal, Customer Service, etc.) to ensure efficient processing
• Liaise with external parties where required (underwriters, Ombudsman office, service providers)

3. Compliance & Quality Assurance:

• Identify potential fraud indicators and escalate
• Maintain accurate and up-to-date records of all claim activities on client's profile
• Ensure all claims are processed within SLA timelines

4. Administration:

• Ensure all Notes and Client interactions are Captured on our Debtor System
• Ensure that the necessary communication is sent via email or SMS to the parties involved
• Document management via multiple channels
• Action any Adhoc responsibilities as provided by Team Leader:
  Prioritise daily, weekly and monthly tasks
• Ensure all leave transactions is captured on ESS
• Ensure all overtime is submitted to Team Manager timeously

5. Adherence:

• Adhere to all Company Policies and Procedures i.e. Absence Management, House Rules, Disciplinary Policy as set out by the business