Life Claims Assessor - 12 month contract

Rand Mutual - RMA; Parktown (NC); Hybrid; USD 15,000 - 21,000; Full time

Benefits offered by this job

Flexible work arrangements

Competitive salary package

Job summary

Rand Mutual Assurance seeks a Life Claims Assessor to adjudicate and process life insurance claims within set guidelines. You will verify claims, gather medical reports, and ensure all documents are properly indexed and synopsized in the system.

You will manage claims to meet targets, review processing against authority limits, and communicate processes to employers and employees. Strong Excel and FAIS knowledge are required, with a focus on accuracy and service.

Qualifications

• Grade 12 qualification/Matric Certificate.
• FAIS Regulatory Examination (RE5) - This is a FAIS compliant role
• NQF Level 5 Higher Certificate in a FAIS Recognised Qualification
• A medical qualification would be advantageous
• Insurance Qualification (advantageous)
• 3 to 5 years claims related experience. General knowledge of the LTI Act
• Intimate knowledge of the FAIS Act
• Intimate knowledge of the GCOC
• Intimate knowledge of the Insurance Act
• General knowledge of the ASISA Standards and Guides
• Good Administrative skills
• Advanced Excel Skills
• Knowledge of Claims processing, approval
• Long Term Insurance experience
• Deadline driven

Responsibilities

• Verify claims captured for correctness and compliance.
• Capture / accept additional information on claims (medical reports).
• Index and file all documents for processing in the system.
• Add notes to provide a clear synopsis of each claim.
• Update requirements on claims to keep them accurate.

Skills

Customer service

Communication skills

Deadline driven

Administrative skills

Insurance industry knowledge

Education

Grade 12 / Matric

NQF Level 5 FAIS recognised

FAIS Regulatory Examination (RE5)

Insurance Qualification (advantageous)

Tools

Excel

Job description

Job Description

THE JOB AT A GLANCE

As a Life Claims Assessor, you will be reporting to the Claims Manager: Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance.

What You Will Do

Claims Adjudication

• Verify claims captured for correctness and compliance
• Capture / accept additional information on claims i.e. medical reports
• Ensure all documents required to process a claim are indexed and filed into the system
• Add meaningful and accurate notes to ensure complete synopsis of claim on the system
• Update requirements on claims and ensure they are always accurate and up to date

Claims Management

• Manage claims in line with individual targets
• Review of claims in line with process, authority limits and within agreed timelines
• Escalate where required within authority limits
• Management of medical reports for claims with Permanent Disability
• Communicate claims process to both the employer and employee as set out in the claim's management processes
• Timeous management of workflows and notifications

Adjudicate and process payments for claims

• Adjudication and processing of TTD benefits including approval within authority limits
• Adjudicating and processing payment of sundry invoices within authority limits
• Process Permanent Disability claims

Customer Service

• Regularly communicate and liaise verbally and in writing with customers/suppliers/visitors/enquirers and relevant staff
• Interpret and respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions
• Manage walk-in queries as and when required in line with the RMA Service Catalogue
• Handle customer inquiries both telephonically and by email
• Research required information using available resources
• Provide customers with accurate product and service information in an efficient manner
• Update existing customer personal information on the system
• Deal with all customers in a professional and empathetic manner

Job Requirements

• Grade 12 qualification/Matric Certificate
• FAIS Regulatory Examination (RE5) - This is a FAIS compliant role
• NQF Level 5 Higher Certificate in a FAIS Recognised Qualification
• A medical qualification would be advantageous
• Insurance Qualification (advantageous)
• 3 to 5 years claims related experienceGeneral knowledge of the LTI Act
• Intimate knowledge of the FAIS Act
• Intimate knowledge of the GCOC
• Intimate knowledge of the Insurance Act
• General knowledge of the ASISA Standards and Guides
• Good Administrative skills
• Advanced Excel Skills
• Knowledge of Claims processing, approval
• Long Term Insurance experience
• Deadline driven

What Youwill Get In Return

We offer great opportunities for personal and professional development in a stable company that's 130 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.

Turnaround time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. Kindly note that should you not receive a response within 21 days please consider your application unsuccessful.

Closing date:

4th October 2026

Our Commitment to transformation:

In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets, preference may be given, but is not limited, to candidates from under-represented designated groups.