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Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

Purpose of the Job

Assessor Support and Scheduling of claims

Critical objectives and responsibilities

Assessor Support and related functions

• Followup 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.
• Adhoc 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
• Adhoc 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.

Experience knowledge & skills required

• 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.

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. Decisionmaking is structured and objective. Initiates necessary investigations. Exercises judgment to assign adjusters or to refer information to attorneys or subjectmatter experts for additional data. Settles and negotiates claims within authorised authority.

Responsibilities

Insurance Claims Administration

Review and analyze assigned insurance claims in line with the organizations standard claims procedures and customer service standards. Engage loss adjusters and/or subjectmatter 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 evidencegathering 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 organizations 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.

Skills

Action Planning Claims Management Claims Settlement Data Compilation Data Controls Executing Plans Financial Auditing Insurance Claims Investigations Insurance Product Management Insurance Sales Oral Communications Presenting Solutions

Competencies

Action Oriented

Collaborates

Drives Results

Ensures Accountability

Financial Acumen

Instills Trust

Manages Complexity

Optimizes Work Processes

Education

NQF Level 3 & NQF Level 2 Below school leaving

Closing Date

29 April 2025 23:59

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

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