Job description
Our Claims division is looking for a Service Assessor who are a meticulous, evidence-led professional who will hold our claims service to the standard our policyholders are promised. The Service Assessor evaluates service quality, compliance, performance standards and customer outcomes — conducting assessments, identifying improvement opportunities and recommending ways to enhance service delivery.
Key Responsibilities
Service Assessment & Evaluation
- Conduct assessments of services, documentation and service delivery processes against established standards, policies and regulatory requirements.
- Gather and analyse evidence to support assessment findings.
- Plan and execute the assessment schedule, selecting samples that are representative and risk-based.
- Conduct file, call and correspondence reviews.
Compliance & Quality Assurance
- Ensure services meet organisational, contractual and regulatory requirements.
- Identify non-compliance, recommend corrective action and monitor implementation of improvement plans.
- Assess adherence to Treating Customers Fairly (TCF) outcomes, the Policyholder Protection Rules and applicable service level agreements.
- Escalate material compliance breaches and repeat failures to the Claims H.O.D. and Compliance without delay.
Reporting & Documentation
- Maintain accurate, confidential records and a defensible audit trail for every assessment.
- Track trends and recurring issues.
- Produce monthly and quarterly quality dashboards for the Claims H.O.D., with root-cause analysis and actionable recommendations.
Continuous Improvement
- Identify opportunities to improve service delivery and operational efficiency.
- Partner with team leaders on coaching, refresher training and process refinements arising from assessment findings.
- Contribute to the review and updating of claims procedures, checklists and service standards.