Claims Administrator

Gavanni Insure; Gauteng; On-site; ZAR 300 000 - 360 000; Full time

Job summary

A leading financial services provider in South Africa is seeking a Claims Administrator. The role involves end-to-end processing of funeral claims, ensuring compliance and efficient handling. Candidates should have at least 3 years of experience in claims administration, exceptional organizational skills, and a strong understanding of South African claims requirements. This full-time position requires in-person work and a RE5 Certificate.

Qualifications

• Minimum 3 years proven experience in claims processing or administration.
• High degree of empathy and professionalism when interacting with clients.
• Strong understanding of South African claims requirements.

Responsibilities

• Receive, log, and vet all incoming funeral claims.
• Request and track outstanding documentation from claimants.
• Ensure each claim is processed in compliance with policy and regulatory guidelines.
• Perform accurate claims calculations and manage claim payment process.
• Maintain communication with claimants regarding status of claims.
• Prepare and submit claims ratio and payment status reports.

Skills

Claims processing

Organizational skills

Empathy

Attention to detail

Communication

Education

RE5 Certificate

Tools

Claims management systems

MS Excel

Job description

About Gavanni Insure: Gavanni Insure is a leading, black‑owned financial services provider specializing in comprehensive group funeral scheme administration.

Our commitment is to provide dignified, reliable, and culturally sensitive support, especially during the claims process, which is the most critical client touchpoint.

We are focused on eliminating historical claims backlogs and ensuring prompt, compliant claim payouts.

Role Summary

The Claims Administrator is responsible for the end‑to‑end processing and settlement of funeral claims.

This is a high‑stakes, administrative role that requires meticulous attention to detail, adherence to regulatory timelines, and high empathy.

The core objective is to ensure claims are handled efficiently, compliantly, and with the utmost sensitivity.

Key Responsibilities

• Claim Submission & Vetting: Receive, log, and meticulously vet all incoming funeral claims and supporting documents against policy requirements and the claims checklist.
• Documentation Management: Request and track all outstanding documentation (e.g., Death Certificate, BI‑certified IDs) from claimants or scheme administrators to ensure claim validity.
• Compliance & Due Diligence: Ensure every claim is processed in full compliance with policy wordings, regulatory guidelines (TCF), and anti‑fraud protocols.
• Claims Processing: Perform accurate claims calculations, submit necessary documentation to the underwriter for final approval, and manage the claim payment process internally.
• Proactive Communication: Maintain clear, empathetic, and professional communication with claimants and scheme administrators regarding status, reason for suspension, or finalization of claims.
• Claims Reporting: Prepare and submit accurate claims ratio, fraud, and payment status reports to management and the finance department daily and weekly.

Minimum Requirements & Skills

• Minimum 3 years proven experience in claims processing or administration, preferably within the Long‑Term Insurance or Funeral industry.
• RE5 Certificate (Regulatory Examination for Representatives).
• Exceptional organizational skills and acute attention to detail are non‑negotiable for managing complex claims documentation.
• High degree of empathy, professionalism, and calmness when interacting with bereaved clients.
• Strong understanding of South African claims requirements (e.g., DHA documentation, FICA).
• Ability to work accurately under pressure to meet time‑sensitive payment deadlines.
• Demonstrated proficiency in claims management systems and MS Excel.

Job Type: Full‑time.

Experience: Claims processing – 3 years (Required).

Language: 2 or more South African languages (Required).

License / Certification: RE 5 (Required).

Work Location: In‑person.