I am a claims desktop assessor and have been for the past 3 years in addition to that i am 3rd year LLB student through long distance learning. My expertise are reading, understanding and applying policy schedules to claims to repudiate or settle the claims.
Forensic Investigation: I am an expert in fraud detection, evidence collection, and digital tracing. Legal Adjudication: I am proficient in interpreting insurance policies to determine claim outcomes, such as settling, pending, or repudiating. Stakeholder Engagement: I am skilled in interviewing key role-players and conducting clear telephonic consultations across diverse linguistic backgrounds with SAPS, Forensic Pathology, and claimants. Documentary Auditing: I have expert knowledge in scrutinizing BI-1663 (Notice of Death) and BI-1680 (Death Report) forms to ensure serial numbers are not duplicates. Data Analytics: I use advanced Excel features like Pivot Tables for trend analysis and risk assessment. Remote Proficiency: I am a self-disciplined professional capable of hitting 100% of monthly KPIs independently in a remote environment. Technical Skills Microsoft Office: I have advanced skills in Excel (Pivot Tables), Word (Mail Merge), PowerPoint, and Outlook. Industry Systems: I am familiar with insurance claims processing software, database management, Bureau Suite, the HPCSA website, and the Masters Court website. Compliance: I possess expert knowledge of the Batho Pele Principles and Standard Operating Procedures (SOP).office administrator
