Administrator: IL Claims Assessment
5 days ago
South Africa
AtripleA recruitment & temps
Full-time
R 220,968 - R 245,520 Contract
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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 hilda@aaaa.co.za
ATripleA Recruitment and Temps