Claims Quality Assurance Technician

Claims Quality Assurance Technician page is loaded Claims Quality Assurance Technicianlocations: Gauteng, Johannesburgtime type: Full timeposted on: Posted Todaytime left to apply: End Date: February 26, 2026 (6 days left to apply)job requisition id: JR104247 Join TIH, home to some of South Africa's leading financial service providers, and grow your career while being part of an organisation with purpose. Job Purpose Responsible for quality auditing of processed claims and claim decisions. Responsible for decision making of claims as and when mandated to do so. Responsibilities Claim Quality Audit and Decisions Conduct complex analyses, quality tests and inspections for already processed claims as well as mandated claims. Insurance Claims Administration Process assigned straightforward insurance claims, ensuring that each claim is supported by valid documentation and supporting evidence, and meeting defined customer service standards. Authorise claims within delegated authority and refer complex or unresolved issues to senior colleagues. Data Collection, Analysis & Reporting Ask questions, collect data from a variety of sources, analyse information and investigate claim. Make decisions according to established criteria to ensure standardisation across the organisation by accurately administrating claims. Contribute to the preparation of various claims reports for Senior Management. Work Scheduling and operational compliance Organise own work schedule in order to get the job done, coordinating with support services and completed work within SLA. Ensure claims are finalised within the set parameters (turnaround time, terms and conditions applied accurately). Remain up to date current and new product knowledge to enable effective decision making. Administration Produce, update and provide best practice support to stakeholders on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs. Document Management Create, organise and maintain files containing the correspondence relating to policies and matters. Education Matric / Grade 12/ SAQA Accredited Equivalent (Essential); Regulatory exam 5 (Advantageous) Experience 1-3 years' claims experience within the Non-Life Financial Services industry (Essential).Our Work Experience is the combination of everything that's unique about our culture, our core values, our company meetings, our commitment to success, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hardworking, curious, trustworthy, humble and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the Top Workplace in our area.