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Claims Analyst

4 months ago

Cape Town, South Africa RGA Full time

**Position Overview**
The Claims Administration Team is looking for a self-motivated individual for a 6 month maternity cover contract who has at least 5 years administration experience to manage the incoming claims and work allocation across the team. The role will require interaction with internal and external clients in response to queries; loading of claims notifications onto the system; and the paying of accounts; as well as other ad hoc projects.

**Responsibilities** Primary Functions of the Role**:

- To co-ordinate all incoming claims documentation for specified clients and manage the workflow of those clients from their loading to payment stage
- Ensure that newly notified claims are entered onto Ira in a timely and accurate manner (within the KPI of that specific company); or entered onto the MA list (where not available on Ira); to ensure that premiums have been received up until and including the date of event; that data is checked and a claim verified manually where it is offline or where Ira shows a payment discrepancy; ensure that OFAC has been performed at notification and payment stage in line with RGA’s international standards; ensure that the claim falls within treaty limits; and ensure that RGA is indeed on risk during the loading of the claim and / or at payment stage
- Ensure that all claims are accurately paid within the agreed service standard and that the claims payment procedure is followed accurately to reduce RGA’s exposure to risk
- Ensure the timeous and accurate completion of monthly reporting and quick turn-around on queries from Finance and Valuations which are related thereto
- To assist in the verification of pending claims with ceding companies on a quarterly basis
- To contribute to streamlining and continuously improving the claims administration process to better meet client expectations and service standards
- Ensure client companies are kept appraised of any administration issues, e.g., delays in payment, etc. and ensure that all clients are promptly and efficiently responded too within stipulated timeframes and procedure notes as provided by the Team Leader
- Assist with ad hoc project work and special claims investigation, internal and external queries, or backlog projects outside of the scope of specified daily and monthly tasks
- Ensure that obstacles impacting the above functions are immediately escalated to the Team Leader, so that timeous resolutions are achieved so that deadlines are maintained, or expectations managed
- To perform client visits and audits where required
- To assist in internal and external audit requirements
- The above functions span both the Individual and Group Life books of business, as well as all benefits related thereto

**Requirements**:

- Minimum of matric
- At least 5 years’ experience in the insurance industry (preferably re-insurance)
- Basic knowledge of insurance products and terminology in SA
- Good understanding of reinsurance and business processing methods
- At least 5 years’ experience in the administration of Individual and Group Life claim
- Computer literacy (Word, Excel, and Outlook)

**Preferred qualities**
- Can work to deadlines
- Can work well under pressure
- Flexible and able to multitask
- Organized and ability to prioritize
- Responsible and accountable - must be able to take on responsibilities and see them through
- Highly motivated self-starter
- Proactive
- Enthusiastic regardless of the task at hand - positive attitude
- Team player with good interpersonal skills
- Excellent written and verbal skills
- Ability to work in a professional corporate environment

Job Reference: SA00312