Living Benefits Claims Consultant

2 weeks ago

Cape Town, Western Cape, South Africa Sanlam Full time

Who We Are?

The Sanlam Retail Affluent business (SRA) aims to empower South Africans in the middle- and upper-income segments to achieve financial confidence and prosperity. With a deep understanding of clients and a focus on excellence in technology, client, and intermediary experiences, SRA offers financial solutions such as comprehensive financial planning, life and disability insurance, credit solutions, savings and investments, retirement, and fiduciary services accessible through various platforms.

What You Will Do?

  • Assess and make independent decisions on complex living benefit claims related to severe illness, disability, and sickness.
  • Ensure that the client's claim request aligns with the policy contract, including interpreting contractual definitions.
  • Collaborate with various stakeholders (Underwriters, Legal Department, Product Development, Medical Doctors, Re-insurers) to resolve complex assessments.
  • Suggest enhancements to the assessment process.
  • Engage in written and verbal communication with clients, intermediaries, underwriters, and doctors throughout the assessment process and on claim outcomes.
  • Take complete ownership of informing clients and intermediaries about claim decisions to prevent complaints.
  • Handle complaints efficiently.
  • Act as a contact person for VIP intermediaries regarding technical inquiries and their clients' claims.

What Will Make You Successful in This Role?

Knowledge & Experience:

  • Experience as an Occupational Therapist or in a clinical role in the medical field.
  • 3-5 years of experience in assessing Living Benefit Claims, Risk claims, or Retail claims.
  • Proficiency in complaints handling.
  • Familiarity with Risk Products and Benefits.

Competencies:

  • Managing complexity effectively.
  • Strong communication skills in English and Afrikaans (written and verbal).
  • Ability to work independently.

Qualification and Experience

Degree or Diploma with 3 to 5 years of relevant experience.

Knowledge and Skills

  • Claims administration.
  • Complex claims settlements and approvals/rejections.
  • Operating within claims guidelines and compliance.
  • Coaching and developing others.

Personal Attributes

  • Business insight - Contributing independently.
  • Efficiently managing complexity.
  • Effective planning and alignment.
  • Conflict management.

Build a Successful Career With Us

We focus on establishing strong relationships with our employees to support their career growth and personal development. As a diversified group, Sanlam provides numerous opportunities for advancement and development across its business clusters.

Core Competencies

  • Promotes innovation independently.
  • Customer-centric approach independently.
  • Achieves results autonomously.
  • Collaborates effectively.
  • Demonstrates resilience.

Turnaround Time

The shortlisting process will commence after the application due date. The duration to complete this process depends on your progress and managerial availability.

Closing Date: 14 June 2024

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