Risk Claims Assessor

Job DescriptionAccurate assessment, investigation and management of long-term insurance claims in accordance with the goals, objectives, processes and standards of the organization to meet customer expectations.Accurate assessment, investigation and management of long-term insurance claims including Health (hospital) Cash claims and critical illness claims.Ensuring that the claims assessment and that the standard of decision is consistent with the company values and philosophy.Ensuring all risks are mitigated and escalated, this includes the identification of fraudulent activity, policy abuse and pre-existing conditions.Providing effective, efficient and professional service to all our customers, advisors and branches, both telephonically and through written correspondence.Taking ownership of queries and ensuring they are resolved timeously and effectively.Ensuring adherence to organisational best practice and legislative requirements.Teamwork to meet service and quality standards.Deliver exceptional service that exceeds customers' expectations through proactive, innovative and appropriate solutions.Additional Requirements
At least 2 years' medical claims assessment experienceWorked with hospitalisation or similar claimsWorked in a Long-term insurance environmentExperience in dealing with Ombudsman / escalated queriesQualifications and Experience
Minimum: MatricNursing background will be advantageous Job Details Application Closing Date
05/07/24 All appointments will be made in line with FirstRand Group's Employment Equity plan. The Bank supports the recruitment and advancement of individuals with disabilities. In order for us to fulfill this purpose, candidates can disclose their disability information on a voluntary basis. The Bank will keep this information confidential unless we are required by law to disclose this information to other parties.


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