Living Benefit Claims Specialist: Disability & Illness

Pivot Services; Centurion; On-site; ZAR 240,000 - 360,000; Full time

Job summary

Pivot Services is seeking a claims assessor to evaluate, review and manage disability, dread disease and income disability claims in line with service levels and company policy. The role requires coordinating with stakeholders to improve the claims experience and maintain accurate records in accordance with relevant legislation.

The ideal candidate will have 1–2 years of claims processing experience and a relevant degree or an equivalent qualification. Grade 12 is essential.

Qualifications

• Desirable relevant degree or qualification in a field related to claims.
• Grade 12 or equivalent qualification is essential.
• 1-2 years experience in processing claims.
• Experience in assessing insurance or medical aid claims, paper and/or EDI preferred.

Responsibilities

• Assess, review and manage disability, dread disease and income disability claims in line with SLAs and policy.
• Partner with stakeholders to improve claims assessment and client experience.
• Advise on and contribute to development of procedures within area of specialisation for quality and service improvement.
• Keep accurate records of all claims assessed per legislation and policy.
• Stay informed on regulatory frameworks and court decisions that could impact claims.
• Assist with continuous improvement to reduce costs and improve quality of decisions and systems.
• Provide testing support for claims systems as part of development and maintenance.

Education

Relevant degree or qualification (Desirable).

Grade 12 or equivalent qualification (Essential).

Job description

Pivot Services is seeking a claims assessor to evaluate, review and manage disability, dread disease and income disability claims in line with service levels and company policy. The role requires coordinating with stakeholders to improve the claims experience and maintain accurate records in accordance with relevant legislation.

The ideal candidate will have 1–2 years of claims processing experience and a relevant degree or an equivalent qualification. Grade 12 is essential.