Quality Assessors (Claims Assessors)
iOCO
- Johannesburg, Gauteng
- Permanent
- Full-time
- Knowledge and understanding of how claims are handled and managed.
- Knows how to identify whether a policy is in force and the next steps in processing a claim notification.
- Knows which exclusions and policy conditions are standard and which are nonstandard. Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential nondisclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures.
- Identifies the most appropriate method of settling claims in line with organizational policies and procedures and in line with authority limits.
- Able to explain fraud and to list the main indicators including any particular to the classes of business being handled.
- Claims and Claims investigation with Research and Analytical.Â
- Customer Relationship Management, able to demonstrate concern for customer expectations and needs.
- Insurance Products and Service
- Customer Advice (Technical) - Claims Knowledge
- Reporting and Interpretation
- Research and Information Gathering
- Claims notification and Investigation
- Knowledge and understanding of the claims notification process
- Knows how claims notification information is used in the claims handling process for own area of business.
- Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential nondisclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures. Knows and applies own organization's reserving philosophy to claims being handled. Follows own organisation's guidelines for referral of claims to stakeholders (eg. early identification of large losses for underwriters and consumers).
- Identifies, investigates, and resolves any issues relating to claims being handled in line with organisational policies and procedures. Identifies when a specialist needs to investigate a claim and follows organizational policies and procedures for appointing these.
- 5 years’ experience in an Insurance environment
- Grade 12
- Bachelor`s Degrees and Advanced Diplomas - Business, Commerce and Management Studies
- Claims Assessor Certificate (NQF4)
- Knowledge and understanding of the range of insurance products and services available in the market
- Skilled in identifying which types of insurance products and services are appropriate to a range of contexts/situations (e.g. critical illness cover, disability cover, income protection, funeral benefits and plans, life protection,
- Skilled in resolving insurance issues in the context of individual, family and/or business offerings. Demonstrates sound knowledge of competitors comparable products and services and their pricing.
- Knowledge and understanding of how claims are handled and managed
- Knows how to identify whether a policy is in force and the next steps in processing a claim notification. Knows which exclusions and policy conditions are standard and which are non standard.
- Identifies and resolves gaps in the key information provided for the class of business being handled.
- Identifies potential non disclosures and misrepresentation and follows organizational procedures to deal with these situations.
- Handles straightforward claims in line with authority limits and adheres to organizational referral procedures. Identifies the most appropriate method of settling claims in line with organizational policies and procedures and in line with authority limits.
- Able to explain fraud and to list the main indicators including any particular to the classes of business being handled.
- Contract Position
- Location: Braamfontein, Johannesburg
- Work environment: Onsite
- Physical demands: Will be sitting the majority of the day doing administrative tasks
- Travel: Own vehicle essentialÂ
Salary: Negotiable
iOCO Infrastructure Services: Where Challengers and Innovators Thrive. We are looking to hire detail-orientated quality assessors (claims assessors) x 7 who will be responsible for upholding and enhancing the quality of service delivery within the organization.  What you’ll do:
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