Funeral & Underwritten Claims Analyst

Sanlam Limited; Johannesburg; Presencial; ZAR 240.000 - 360.000; Jornada completa

Descripción de la vacante

MiWayLife Parktown in Gauteng seeks a dedicated Claim Assessor to evaluate funeral and underwritten claims, ensuring adherence to policies, regulatory requirements and service standards.

The role reports to the Operations Manager: Claims and involves analysing documentation, applying policy terms, identifying fraud indicators and maintaining precise audit trails while collaborating with internal and external stakeholders to resolve complex claims.

Formación

• Grade 12/Matric is required.
• Relevant qualification in Insurance, Business Management, Commerce, or related field advantageous.
• Minimum 2–3 years’ experience in claims assessment within long term Insurance or Financial Services.
• Experience interpreting policy contracts.
• Assessor certification / Nursing or medical background experience.

Responsabilidades

• Assess and adjudicate funeral and underwritten claims within service levels.
• Request and analyse supporting documentation and medical information where applicable.
• Apply policy terms, conditions, and underwriting principles when making claim decisions.
• Identify potential fraud indicators and escalate suspicious claims.
• Communicate claim outcomes professionally to stakeholders.
• Maintain accurate claims records and audit trails.
• Collaborate with internal and external stakeholders to resolve complex claims.
• Contribute to process improvement initiatives within the Claims.

Conocimientos

Analytical thinking

Investigative skills

Communication skills

Attention to detail

Problem solving

Planning prioritising

Stakeholder management

Confidentiality

Computer literacy

Educación

Grade 12/Matric

Insurance qualification advantageous

Herramientas

Claims systems

Descripción del empleo

MiWayLife Parktown in Gauteng seeks a dedicated Claim Assessor to evaluate funeral and underwritten claims, ensuring adherence to policies, regulatory requirements and service standards.

The role reports to the Operations Manager: Claims and involves analysing documentation, applying policy terms, identifying fraud indicators and maintaining precise audit trails while collaborating with internal and external stakeholders to resolve complex claims.