Claims Administrator

Job Ref #: TFS-849
Industry: Call Centre
Job Type: Permanent
Positions Available: 5

The Claims Administrator is responsible for managing, processing, and finalizing customer claims in accordance with company policies, service-level agreements (SLAs), and regulatory requirements. The role ensures accurate documentation, timely communication, and effective resolution of claims while delivering exceptional customer service and maintaining data integrity.

Job Description

The Claims Administrator is responsible for managing, processing, and finalizing customer claims in accordance with company policies, service-level agreements (SLAs), and regulatory requirements. The role ensures accurate documentation, timely communication, and effective resolution of claims while delivering exceptional customer service and maintaining data integrity.

Key Performance Areas:

1. Daily activities:

• Receive, review, and register new claims on the system
• Validate all claim documentation for completeness and accuracy
• Process and Assess claims in line with company guidelines and policy terms
• Maintain accurate and up-to-date records of all claim activities on clients Einstein profile
• Resolve queries efficiently and maintain a high standard of service delivery

2. Customer Service & Stakeholder Communication:

• Contribute to process improvement initiatives to enhance customer experience
• Communicate claim outcomes, requirements, and updates to customers timeously
• Engage with internal departments (Finance, Legal, Customer Service, etc.) to ensure efficient processing
• Liaise with external parties where required (underwriters, Ombudsman office, service providers)

3. Compliance & Quality Assurance:

• Identify potential fraud indicators and escalate
• Maintain accurate and up-to-date records of all claim activities on client's profile
• Ensure all claims are processed within SLA timelines

4. Administration:

• Ensure all Notes and Client interactions are Captured on our Debtor System
• Ensure that the necessary communication is sent via email or SMS to the parties involved
• Document management via multiple channels
• Action any Adhoc responsibilities as provided by Team Leader: Prioritise daily, weekly and monthly tasks
• Ensure all leave transactions is captured on ESS
• Ensure all overtime is submitted to Team Manager timeously

5. Adherence:

• Adhere to all Company Policies and Procedures i.e. Absence Management, House Rules, Disciplinary Policy as set out by the business

Job Requirements

Qualifications:

• Grade 12 / NQF Level 4 Experience in a claims processing environment within a contact centre

Experience:

• Experience working in a claims process environment within a contact centre
• Knowledge of claims processing (technical aspect) and substantial administrative experience

You are welcome to apply if you meet the outlined minimum requirements. Please send your application to ************@tenacityinc.co.za, if you are interested in applying.

Please consider your application unsuccessful if you have not received a response within 4 weeks of applying.

By submitting your application, you’re giving Tenacity implicit consent to the storage and processing of your personal Information.

Tenacity is committed to creating equal employment opportunities that are aligned with our Employment Equity Plan.

Closing Date: 18 September 2026 at 12h00pm