SENIOR CLAIMS ADMINISTRATOR /ASSESSOR (INDIVIDUAL LIFE INSURANCE)
Salary highly negotiable (dependent on experience)

Are you a Senior Claims Administrator / Claims Assessor, with 3+ years individual life insurance claims administration experience?

You must be able to gather all the required documentation, and in accordance with the terms and conditions of the policy contract, must be able to assess and evaluate whether it is a valid permanent disability claim. You have to have the relevant skills and experience background, as well as training to be able to make claim decline or admit decisions.

Are you keen to join a dynamic company with a relaxed, professional and positive working environment?
Want to work in the Southern suburbs?

If “yes” to the above then read on…

• Our client’s Administration team requires a Senior Claims Administrator who will take responsibility for:
• Process and check individual life claims (death, lump sum disability, cancer, critical illness, retrenchment, road accident injury and temporary disability claims)
• Doing regular follow-ups to obtain outstanding claim documentation
• Maintain and update claims register
• Create new and maintaining existing claim related templates and documentation (eg claim declined letters, request for outstanding claim documentation, checklists, claim forms etc)
• Interacting with medical aids, hospitals and medical practitioners regarding medical history required and relevant to assessing the claim.
• Assessing claims and making final claim decision (a prerequisite)
• Liaising with the reinsurance companies regarding the claim decision
• Dealing with client queries.
• Arranging for claim payments and Reinsurance funds
• Dealing with Ombud cases, complaints and disputes
• Drafting reports and compiling time lines for management
• Other administration related functions
• Answering the telephone and resolving the call compiling the claim data files required by the Auditors

ESSENTIAL QUALIFICATIONS & EXPERIENCE REQUIRED:
• Bachelor of Science in any medical related field or similar qualification
• Individual Life Insurance claims assessing experience (3 + years)

Intermediary MS Office (esp. Excel, Word and Microsoft Outlook skills) and very good written and verbal communication skills are necessary, as well as the ability to work with a high level of accuracy and attention to detail. To be considered, the ability to work well under pressure and to meet daily targets is also a must have.

Please note - that should you not hear from us within 7 working days, consider your application for this vacancy unsuccessful.