Senior Claims Assessor

TalentCru; Johannesburg; On-site; ZAR 30 000 - 60 000; Full time

Job summary

An innovative firm in the telecommunications sector is on the lookout for a dedicated Senior Claims Assessor. This role is pivotal in evaluating and processing various claims, ensuring they meet the required criteria for payout. If you possess exceptional analytical skills and a keen eye for detail, this 12-month contract offers a chance to make a significant impact in the lives of individuals facing critical situations. Join a team that values transparency and accountability in claims assessment, and contribute to a supportive environment where your expertise can shine.

Qualifications

• 2-4 years of experience in Group Schemes administration or claims.
• Strong organizational and investigation skills are essential.

Responsibilities

• Evaluate and process death, critical illness, and disability claims.
• Liaise with employers and service providers to resolve claims queries.

Skills

Analytical Skills

Attention to Detail

Problem-Solving

Decision-Making

Communication Skills

Education

Matric Certificate

RE 5 - Representative

Claims Assessment Certificate

Tools

Microsoft Word

Microsoft Excel

Job description

Our client in the telecommunications industry is seeking a dedicated Senior Claims Assessor to join their team and make a real difference in people's lives. This individual will play a crucial role in evaluating and processing death, critical illness, disability, and incapacity claims. They must assess the validity of claims and ensure that they meet the stipulated criteria for payout. Therefore, if you are the candidate we are looking for, with incredible attention to detail, excellent analytical skills, and the ability to make fair and informed decisions, this is a 12-month contract!

Position Details

• Matric Certificate, Computer literacy (Advanced Word and Excel)
• RE 5 - Representative
• Certificate related to claims assessment or long-term insurance
• 2-4 years of Group Schemes administration / claims experience with expert-level understanding of benefits offered in the risk benefits portfolio (e.g., Death, Disability, Incapacity)
• Strong organizational awareness, investigation skills, problem-solving, and decision-making abilities
• Perform all death claims related activities, including claim processing, responding to claims-related queries, and complaints
• Application of fund rules, policies, legislation, administration procedures, and service level agreements when processing claims
• Meet production standards in terms of quantity and quality
• Liaise with employers and service providers
• Attend to the fund's central mailbox and respond to queries within SLA
• Participate in organizational events as required
• Draft resolution letters
• Good verbal and written communication skills
• Ability to work under pressure, be target-driven, and meet deadlines
• Investigate and report fraudulent claims
• Handle complaints effectively
• Contribute to transparent and accountable claims assessment processes through reporting
• Assist with upskilling junior assessors and approve overrides within your mandate