Senior Claims Assessor

Talentcru; Johannesburg; On-site; ZAR 300,000 - 450,000; Full time

Job summary

A leading company in the telecommunications industry is seeking a Senior Claims Assessor for a 12-month contract. This role involves evaluating and processing various claims, requiring strong analytical skills, attention to detail, and a focused approach. Candidates should have relevant qualifications in claims assessment and a solid understanding of risk benefits.

Qualifications

• 2-4 years of Group Schemes administration / claims experience.
• Strong organizational awareness and investigation skills.
• Experience in claims assessment processes.

Responsibilities

• Evaluating and processing death, critical illness, disability, and incapacity claims.
• Assessing the validity of claims and ensuring they meet payout criteria.
• Liaising with employers and service providers while responding to claims queries.

Skills

Attention to detail

Analytical skills

Decision-making abilities

Problem solving

Verbal communication

Written communication

Investigative skills

Education

Matric Certificate

RE 5 - Representative

Certificate related to claims assessment or long-term insurance

Tools

Advanced Word

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. If you possess incredible attention to detail, excellent analytical skills, and the ability to make fair and informed decisions, this 12-month contract could be your next opportunity.

Position Requirements:

1. Matric Certificate, Computer literacy (Advanced Word and Excel)
2. RE 5- Representative
3. Certificate related to claims assessment or long-term insurance
4. 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)
5. Strong organizational awareness, investigation skills, problem solving, and decision-making abilities
6. Perform all death claims-related activities, including claim processing, responding to claims queries and complaints
7. Application of fund rules, policies, legislation, administration procedures, and service level agreements when processing claims
8. Meet production standards in terms of quantity and quality
9. Liaise with employers and service providers
10. Attend to the fund central mailbox and respond to queries within SLA
11. Draft resolution letters and handle complaints effectively
12. Good verbal and written communication skills
13. Ability to work under pressure, be target-driven, and meet deadlines
14. Investigate and report fraudulent claims
15. Contribute to transparent and accountable claims assessment processes through reporting
16. Upskill junior assessors and assist with overrides and approvals within your mandate