Administrator: IL Claims Assessment (Insurance), Soweto

Administrator: IL Claims Assessment

Location: Pretoria, South Africa

Salary: R19 800 - R22 000

Our client in the Insurance industry is looking for an Administrator: IL Claims Assessment.

Key responsibilities

Assessing and processing of life and funeral claims

Process funeral and life claims and prepare for claims approval process within 48hrs of receipt

Verify premiums paid on the system prior to assessing claims

Verify deceased and beneficiaries against main policy on the system

Confirm the policy holder's relationship to the deceased

Liaise with Re‑insurers where necessary on Life cover policies below R300 000.00

Refer suspicious fraudulent claims to Specialist administrator

Discuss complex claims with in‑house professional advisor and consultants

Follow up timeously on all outstanding claims

Liaise with relevant stakeholders on outstanding and incorrect Id numbers and where the person is covered on the application form but does not exist on the system

Liaise with Client services where the deceased died before the policy become inactive. To activate the policy prior to assessing

Responsible for identifying disputes and complaints of complex claims

Recommend a solution to Senior Manager where a claim arises a day before the 6 month waiting period expires

Update AIMS notes on system

Be a 2nd validator on captured and authorized claims

Give feedback on follow‑up claims to Section leader

Forward a spreadsheet of all finalized claims to Section Leader

Claims pay‑out

Confirm status of the claim if it is approved or declined

Where the age of the deceased differs with the one on the system, apply the penalty formula

Recommend decline/payment of claims

Double check the consistency on banking details attached to the claim and the one on the system

Forward the claim to Manager for payment

Check the finance list and sign off

Reconcile information received, processed and finalized

Compile monthly individual statistics

Compile all branch registers month end (Death)

Present challenges experienced and solutions taken to resolve them

Requirements

Matric

NQF 4 in Insurance (Advantage)

2 years life insurance in claims

Intermediate MS Office Word, Excel, PowerPoint

Send your CV and latest pay slip to

ATripleA Recruitment and Temps

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