Administrator: IL Claims Assessment (Insurance)

AtripleA recruitment & temps; South Africa; On-site; ZAR 220,968 - 245,520; Full time

Job summary

A recruitment agency in Pretoria seeks an Administrator for IL Claims Assessment. The role involves processing life and funeral claims, verifying premiums, and liaising with stakeholders. Candidates should have a Matric qualification and preferably an NQF 4 in Insurance, along with 2 years of experience in life insurance claims. Proficiency in MS Office is required. Salary ranges from R19,800 to R22,000 monthly.

Qualifications

• Matric is mandatory.
• NQF 4 in Insurance is an advantage.
• 2 years of experience in life insurance claims.

Responsibilities

• Assess and process life and funeral claims.
• Verify premiums paid before assessing claims.
• Liaise with re-insurers for life cover policies.

Skills

Attention to detail

Communication

Analytical skills

Education

Matric

NQF 4 in Insurance

Tools

MS Office (Word, Excel, PowerPoint)

Job description

Administrator: IL Claims Assessment

Location: Pretoria, South Africa

Salary: R19 800 - R22 000

Our client in the Insurance industry is looking for an Administrator: IL Claims Assessment.

Key responsibilities

• Assessing and processing of life and funeral claims
• Process funeral and life claims and prepare for claims approval process within 48hrs of receipt
• Verify premiums paid on the system prior to assessing claims
• Verify deceased and beneficiaries against main policy on the system
• Confirm the policy holder's relationship to the deceased
• Liaise with Re‑insurers where necessary on Life cover policies below R300 000.00
• Refer suspicious fraudulent claims to Specialist administrator
• Discuss complex claims with in‑house professional advisor and consultants
• Follow up timeously on all outstanding claims
• Liaise with relevant stakeholders on outstanding and incorrect Id numbers and where the person is covered on the application form but does not exist on the system
• Liaise with Client services where the deceased died before the policy become inactive. To activate the policy prior to assessing
• Responsible for identifying disputes and complaints of complex claims
• Recommend a solution to Senior Manager where a claim arises a day before the 6 month waiting period expires
• Update AIMS notes on system
• Be a 2nd validator on captured and authorized claims
• Give feedback on follow‑up claims to Section leader
• Forward a spreadsheet of all finalized claims to Section Leader

Claims pay‑out

• Confirm status of the claim if it is approved or declined
• Where the age of the deceased differs with the one on the system, apply the penalty formula
• Recommend decline/payment of claims
• Double check the consistency on banking details attached to the claim and the one on the system
• Forward the claim to Manager for payment
• Check the finance list and sign off

Reconcile information received, processed and finalized

• Compile monthly individual statistics
• Compile all branch registers month end (Death)
• Present challenges experienced and solutions taken to resolve them

Requirements

• Matric
• NQF 4 in Insurance (Advantage)
• 2 years life insurance in claims
• Intermediate MS Office Word, Excel, PowerPoint

Send your CV and latest pay slip to [e-mail]

ATripleA Recruitment and Temps