Assessor Support Consultant-(6 Months Fixed Term Contract )

job Description

Purpose of the Job
Assessor Support and Scheduling of claims

Assessor Support and related functions
-Follow-up on outstanding information as and when required and request by the assessor and update claims notes.
-Liaise with claims stakeholder as and when required and update the claims notes.
-Administrative and telephonic support to assessors, with an objective of reducing the administrative burden on assessors.
-Ad-hoc duties as and when required

Scheduling of claims
-Accurate and efficient allocation of claims to internal/ external assessors and suppliers.
-Equitable allocation of in line with business objectives and targets

Claims Scheduling Improvement Initiatives
-Digital Claims Assessment Process
-Claims cost reduction initiatives
-Ad-hoc duties as and when required

Service delivery to ensure customer satisfaction
-Maintain service, quality and desired outputs within a specific functional process through ensuring compliance to tactical policies, procedures and standards.
-Establish productive operational relationships with key stakeholders in the various channels and administrative teams.
-Develop work routines in line with operational plans / schedules in order to manage achievement of service delivery goals.
-Share knowledge on, and participate in the creation of new standards, control systems and procedures to maintain service delivery.

Cost control and governance adherence
-Proactively ensure use of time, of resources, money, materials or equipment is in line with policies and procedures.
-Comply with corporate governance policies, procedures and standards.
-Operate within agreed mandates.

Quality people practices:
-Align own behaviour with the organisation culture and values.
-Share and transfer product, process and systems knowledge to colleagues.
-Ensure achievement of own performance objectives.
-Actively share information with other team members regarding successes, issues, trends and ideas.
-Actively participate in own professional development and career path.
-Actively promote a culture of learning and high performance culture amongst team members.

Duties and Responsibilities

Insurance Claims Administration
Review and analyze assigned insurance claims in line with the organization's standard claims procedures and customer service standards. Engage loss adjusters and/or subject-matter experts where appropriate, authorize claims within delegated authority, and refer complex or unresolved issues to senior colleagues.

Insurance Claims Evaluation
Interview and/or visit claimants to evaluate the extent of liability and the value of insured losses in line with policy coverage. Adjust losses and negotiate settlement within delegated authority limits, referring complex or disputed claims to senior colleagues for resolution.

Fraud/Financial Crime Investigation
Carry out assigned information and evidence-gathering activities to support the investigation of cases of suspected fraud or financial crime and the instigation of criminal investigations and/or legal actions.

Fraud/Financial Crime Management
Use established prevention models, systems, and protocols to monitor client or customer activities or transactions, informing more senior colleagues about suspicious activities.

Operations Management
Provide operational support by performing a range of routine activities using existing systems and protocols.

Solutions Analysis
Find the most effective ways to respond to routine functional inquiries. Involves following procedures and precedents.

Document Preparation
Prepare moderately complex documents using a variety of applications for technology devices, such as standard office software. Also responsible for gathering and summarizing data for reports.

Resolving Customer Issues
Respond to basic issue escalations promptly and appropriately; provide managerial approvals as required.

Regulatory and Compliance Management
Carry out a wide range of compliance monitoring activities and give basic advice on compliance and regulatory requirements.

Operational Compliance
Develop knowledge and understanding of the organization's policies and procedures and of relevant regulatory codes and codes of conduct to ensure own work adheres to those standards. Obtain authorization from a supervisor or manager for any exceptions from mandatory procedure.

Personal Capability Building
Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.

Qualifications and Experience

-Grade 12
-1 – 2 years’ experience in an administrative role
-Previous claims experience or Insurance Learnership would be advantageous
-Knowledge and experience using the Microsoft Office suite, specifically MS Projects, Excel and PowerPoint.
-NQF Level 3 & NQF Level 2 - Below school leaving

Handles a variety of coverage with a defined loss potential. Reviews and proceses claims of low to moderate face value or liability against policies and coverage information. Decision-making is structured and objective. Initiates necessary investigations. Exercises judgment to assign adjusters or to refer information to attorneys or subject-matter experts for additional data. Settles and negotiates claims within authorised authority.