Job Description

• Claims Processing: Receive, review, assess and calculate claims in accordance with policy requirements.
• Document Verification: Analyze claim documentation, ensuring completeness and accuracy before processing payments.
• Customer Engagement: Communicate with customers and other stakeholders to provide updates on claim statuses and requirements.
• Regulatory Compliance: Ensure all claims adhere to internal policies, regulatory requirements, and industry best practices.
• Risk Management: Assess potential risks in claims processing, implement strategies to mitigate financial and reputational risks, and ensure early detection of fraudulent claims.
• Reporting: Prepare and maintain accurate claim records and reports for management review.
• Process Improvement: Recommend and implement improvements to claims procedures to enhance efficiency and customer satisfaction.
• Any other duties assigned from time to time

Provides a positive customer experience by being helpful and sensitive to customer needs, managing expectations and providing solutions including directing customers to the correct channel in adherence to procedural, productivity and quality standards. Provides specialist product and service knowledge that may lead to sales generation.

Responsibilities 

• Provide advanced product/service information and respond to basic customer questions about the product/service.
• Customer Order Processing
• Record and process custom/special customer orders, often dealing with ambiguous delivery expectations.
• Resolving Customer Issues
• Respond to basic issue escalations promptly and appropriately; provide managerial approvals as required.

Customer Relationship Development / Prospecting

Make calls (by telephone or in person) to allocated customers to develop new relationships. Act as a first point of contact for resolving customer queries and complaints.

Customer Relationship Management (CRM) Data

Schedule follow-up actions and enter relevant information into the CRM system after each contact with a customer to create a call plan and to ensure that the organization has quality data to enable effective customer retention and business development activities.

Customer Needs Clarification

Interview the customer, following a complex multilevel sales script, to clarify the customer’s requirements, or assist in conducting interviews with potential customers, making detailed notes to collect client requirements.

Renewals

Provide exceptional service to customers to encourage continued use of the organization’s products/services.

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.

Skills 

• Consultative Selling, Customer Complaint Management, Customer Feedback Management, Customer-Focused, Customer Relationship Management (CRM) Software, Customer Service, Customer Service Operations, Customer Understanding, Data Management, Digital Consumer Engagement, Identifying Sales Opportunities, Probing Questions, Sales Data Management, Strengthening Customer Relationships, Upselling

Competencies 

• Action Oriented
• Communicates Effectively
• Customer Focus
• Decision Quality
• Ensures Accountability
• Interpersonal Savvy
• Manages Ambiguity
• Manages Complexity

Education

• Bachelor Of Commerce Insurance Science: Business Administration

How to apply

• To apply for this job please visit oldmutual.wd3.myworkdayjobs.com.
• Apply by 14 May 2026 at 23:59hrs