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AtripleA Recruitment and Temps
Pretoria, 2000, South Africa

Company Profile


Senior Assessor IL Claims (Insurance)


col-narrow-left   

Job ID:

16888

Location:

Pretoria, 2000, South Africa 

Category:

Insurance

Salary:

R23,800.00 per month
col-narrow-right   

Job Views:

991

Employment Type:

Full time

Posted:

10.22.2018
col-wide   
Fax your CV to 0864810554

Job Description:

Senior Assessor IL Claims (Insurance)
Location: Menlyn, Pretoria
Salary: R23 800 p.m.
           
Our client in the Insurance industry is looking for a Senior Assessor IL Claims to assess Funeral and Life cover claims.
 
 
Key responsibilities
 
  1. 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 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 spread sheet of all finalized claims to Section Leader
 
  1. 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
 
  1. Reconcile information received, processed and finalized
 
  • Compile monthly individual statistics
  • Compiling all branch registers month end (Death)
  • Present challenges experienced, and solutions taken to resolve them
 
 
 
 

Job Requirements:

Requirements            
                               
  • NQF 4 in Insurance
  • 2 years life insurance in claims
  • Matric
 
 
 
Send your CV and latest pay slip to hilda@aaaa.co.za
ATripleA Recruitment and Temps
www.aaaa.co.za


Company Info


AtripleA Recruitment and Temps
Pretoria, 2000, South Africa

Senior Assessor IL Claims (Insurance)

col-narrow-left   

Job ID:

16888

Location:

Pretoria, 2000, South Africa 

Category:

Insurance

Salary:

R23,800.00 per month
col-narrow-right   

Job Views:

991

Employment Type:

Full time

Posted:

10.22.2018
col-wide   
Fax your CV to 0864810554

Job Description:

Senior Assessor IL Claims (Insurance)
Location: Menlyn, Pretoria
Salary: R23 800 p.m.
           
Our client in the Insurance industry is looking for a Senior Assessor IL Claims to assess Funeral and Life cover claims.
 
 
Key responsibilities
 
  1. 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 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 spread sheet of all finalized claims to Section Leader
 
  1. 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
 
  1. Reconcile information received, processed and finalized
 
  • Compile monthly individual statistics
  • Compiling all branch registers month end (Death)
  • Present challenges experienced, and solutions taken to resolve them
 
 
 
 

Job Requirements:

Requirements            
                               
  • NQF 4 in Insurance
  • 2 years life insurance in claims
  • Matric
 
 
 
Send your CV and latest pay slip to hilda@aaaa.co.za
ATripleA Recruitment and Temps
www.aaaa.co.za