Assessor: Claims

Who we are is because of our people.

We invest in them because they make us better. We value our people, putting our customer’s first, working fast and smart and doing the right thing. TFG is a diverse, multi- faceted retail lifestyle group, woven into the lives of millions. We exist to genuinely be a part of our customer’s lives and we are passionate about inspiring our customers to live their best lives.

Our vision is to create the most remarkable omnichannel experiences for our customers.

The Value Added Services division within TFG offers a host of insurance product in the Life and Non-Life product spectrum to all existing and new TFG customers under the TFG Insure brand. The Insurance Claims Department offers the support function of managing the insurance claims initiated by customers on their existing insurance policies in an event of a claim event.

The Claims Assessor incumbent will be responsible for efficiently processing an insurance claim against a TFG Insure product in line with the terms and conditions of the insurance policy and clearly outlined business processes and turnaround times. The Claims Assessor will report to the Team Leader within the Insurance Claims Department.

• Manage claims for all insurance products on the various claim’s platforms from receipt to finalisation.
• Manage customer expectations throughout the claims process.
• Manage all incoming and outbound calls on the Insurance Claims Share call within the specified service levels.
• Ensure service levels are met in line with the Claims Management Framework and regulatory requirements.
• Build a rapport and collaborate with all internal and external stakeholders to effectively manage customer needs.
• Ensure FICA screening is conducted during the customer onboarding and claims process.
• Policy administration post a claim to ensure all customer’s policies are kept up to date:
• Capturing and updating information on various insurance platforms as directed by the policyholder.
• Any other policy administrative functions that might be required of them as the need arises.

• Must have Matric/Grade 12 or equivalent thereof – Essential
• 2 years customer service experience - Essential
• 1 Year minimum Claims assessing, and validation experience is a requirement – Essential

• Be proficient in Excel, Word
• Experience working on Claims Management systems and platforms
• Be logical and apply analytical thinking skills
• Must have numerical ability
• Be able to problem solve, handle objections and conflict.
• Be attentive to information and detail
• Be organised, thorough and accurate
• Have good time management skills
• Be assertive and able to work well under pressure
• Have a high level of stress tolerance
• Be an effective communicator (verbal, written, electronic, and interpersonal)
• Be organised and able to work in a systematic manner
• Be a team player and be able to work independently when required to.

• Demonstrated knowledge of and skill in adaptability, decision making, interpersonal relations, problem solving, teamwork & written communication
• Comfortable and effective influencer.
• You need to be flexible as the environment is very dynamic and priorities can change.
• Sets ambitious goals and takes focused action to achieve desired outcomes to deliver measurable results
• Adapts effectively to situations that are complex, uncertain, or lack guidelines and clear information
• Interprets and simplifies complex and contradictory information when resolving organisational problems
• Interpreting and applying understanding of key financial indicators to make better business decisions.
• Assesses and improves the efficiency, effectiveness, and quality of various work processes
• Develops plans and prioritises initiatives that align to the organisational goals and objectives
• Effectively adjusts their behaviour, approach, and decision-making based on the situation
• Thinks and plans strategically, focusing on the long-term goals and objectives of the organisation
• Manage time effectively in order to meet expected deliverables within specified time frame

Please ensure your Line Manager is aware and supports your application.
Preference will be given, but not limited to candidates from designated groups in terms of the Employment Equity Act.