Remote Life Claims Specialist

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

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.