Our client in the telecommunications industry is seeking a dedicated Senior Claims Assessor to join their team and make a real difference in people's lives.
This individual will play a crucial role in evaluating and processing death, critical illness, disability and incapacity claims.
They must assess the validity of claims and ensure that they meet the stipulated criteria for payout.
Therefore, if you are the candidate we are looking for, with incredible attention to detail, excellent analytical skills, and the ability to make fair and informed decisions, it is a 12-month contract! Matric Certificate, Computer literacy (Advanced word and Excel)RE 5- RepresentativeCertificate related to claims assessment or long-term insurance2-4 years Group Schemes administration /claims experience expert level understanding of benefits offered in the risk benefits portfolio e.g.
Death, Disability, Incapacity, and ECT...Must have strong organizational awareness, Investigation skills, problem solving, decision makingPerform all death claims related activities which include - claim processing, responding to claims related queries and complaintsApplication of fund rules, policies, legislation, administration procedures and the service level agreement when processingMeet production standards in terms of quantity and qualityLiaise with employers and service providersAttend to the fund central mailbox and respond to queries within SLAAny other duties as determined by business needs and participate in all organizational events as requiredDrafting of resolution lettersGood administrative skillsGood communication skills, verbal and writtenAbility to work under pressure, be target driven and meet deadlinesAbility to investigate and report fraudulent claimsComplaints handlingFulfil reporting functions, contributing to a transparent and accountable claims assessment processInvestigate and report fraudulent claims, actively participating in complaints handlingMeet production standards for both quantity and quality, demonstrating excellent administrative skillsRespond to queries and complaints promptlyUpskilling of the junior assessorsAssisting with Junior assessors overrides and approvals within your mandate