Claims Assessor

4 weeks ago


Centurion, South Africa Momentum Life Full time

**Introduction**Role Purpose**
- To be part of a team that provides market leading claims assessment capability for living benefits (critical illness, income and disability benefits). This will include specialising in income disability, lump sum disability,critical illness and case management for living benefits, the completion of quality industry assessments within the required service levels.**Requirements**:

- B./BSc. Occupational Therapy, Physiotherapy or Psychology or Qualified Registered Nurse or other health sciences related degree considered appropriate.
- 1-3 Experience in life insurance claims.
- Relevant insurance knowledge, applicable regulatory requirements and legislations (beneficial).
- Experience of general retail protection market product offerings (beneficial)

**Duties & Responsibilities**
- Execution of the claims assessment methodology across Critical Illness, Income Protection and Lump Sum Disability benefit lines.
- Approves or declines claim submissions without supervision within company guidelines.
- Support team members with best practice techniques,medical practice through knowledge sharing.
- Selects and accepts major risks on behalf of the company, evaluating proposals rather than mechanistic assessment.
- Assist with the overall improvement of risk management within the living benefits assessment area.
Current best industry and company practices.
Claims research.
Technological enablers.
To partner and collaborate with both internal and external stakeholders, not limited to product development,underwriting, CMO, reinsurance partners to improve claims assessment and client experience.
- Ensure that assessment methodology and execution is in line with legislation and best practices within the financial management field in order to optimise the claims assessment service offering and deliver.
- Familiar with the regulatory framework, insurance related court decisions and/or determinations by regulatory bodies, governing bodies etc. that could impact the way claims are processed or handled.
- Risk opportunity identification to prevent fraud and to deliver quality work.
- Build and maintain relationships with internal stakeholders responsible for the primary client.
- Build and maintain relationships with internal stakeholders responsible for the primary client and advisor interactions (claims consultants).
- Follow internal client service practices which build rewarding relationships and enables exceptional client service
- Contribute to a client service excellence culture which builds enduring relationships and allows team to provide exceptional client service.
- Incorporate internal assessment feedback into the enhancement of daily business processes and management operating systems.
- Act in a way that allows for a positive work climate and culture with fellow employees.

**Competencies**
- Business acumen.
- Client / Stakeholdercommitment.
- Assertiveness.
- Drive for results.
- Diversity and inclusiveness.
- Collaboration and team work.
- Impact and influence.
- Results and solution focused.
- Self-awareness and insight.
- Diversity and inclusiveness.


  • Claims Assessor

    2 weeks ago


    Centurion, South Africa Momentum Life Full time

    **Introduction**Role Purpose** - To provide a support service to the claims department by liaising with clients and stakeholders as well as providing solutions.**Requirements**: - 2-3 years exposure to the Life Insurance industry - 2-3 years claims experience (preferred) - Call centre knowledge - Knowledge of medical terminology (preferred) -...


  • Centurion, South Africa Momentum Life Full time

    **Introduction**Role Purpose**Requirements**: - Relevant Insurance/Financial services Industry knowledge and experience, applicable regulatory requirements, and legislations. - Extensive knowledge of Section 37C of the Pension Funds Act. (essential). - 5 years proven track record in a leadership role/people management (essential). - MS Office Suite (Word,...

  • Claims Assessor

    2 weeks ago


    Centurion, Gauteng, South Africa Momentum Life Full time

    IntroductionRole Purpose**- To provide a support service to the claims department by liaising with clients and stakeholders as well as providing solutionsRequirements: 23 years exposure to the Life Insurance industry 23 years claims experience (preferred) Call centre knowledge Knowledge of medical terminology (preferred) MatricDuties & Responsibilities...


  • Centurion, South Africa Momentum Corporate Full time

    **Introduction** **Role Purpose** Ensure the smooth running of the disability management administration function by efficient coordination of related tasks. To provide an effective and efficient service to clients and intermediaries by receiving, evaluating and responding to queries timeously. Accurately capture incoming correspondence and claims onto the...

  • Claims Assessor

    2 weeks ago


    Centurion, Gauteng, South Africa Health Solutions Full time

    IntroductionMetropolitan is one of the oldest financial services brands in South Africa. With a 116 year legacy of serving the communities in which it operates, Metropolitan represents true empowerment in serving Africa's people through affordable financial solutions that create financial growth and security.Role PurposeAssess, review and manage living...


  • Centurion, Gauteng, South Africa Momentum Corporate Full time

    IntroductionRole PurposeEnsure the smooth running of the disability management administration function by efficient coordination of related tasks. To provide an effective and efficient service to clients and intermediaries by receiving, evaluating and responding to queries timeously. Accurately capture incoming correspondence and claims onto the relevant...


  • Centurion, South Africa OUTsurance Full time

    Company Description OUTsurance is a customer-centric financial services company with a global foot print. We are vibrant, successful and values orientated with an awesome dynamic culture encapsulated by the ethos that clients and staff “always get something OUT.” Our success can be attributed, amongst other things, to the outstanding people that work...

  • Claims Assessor

    2 weeks ago


    Centurion, Gauteng, South Africa MMI Holdings Ltd Full time

    Closing Date2023/03/20Reference NumberMMH Job TitleClaims AssessorPosition TypePermanentRole FamilyClient ServicesClusterHealth SolutionsRemote OpportunitySome of the timeLocation - CountrySouth AfricaLocation - ProvinceGautengLocation - Town / CityCenturionIntroduction Metropolitan is one of the oldest financial services brands in South Africa. With a 116...

  • Claims Assessor

    4 weeks ago


    Centurion, South Africa MMI Holdings Ltd Full time

    Closing Date2023/03/20Reference NumberMMH230301-6Job TitleClaims AssessorPosition TypePermanentRole FamilyClient ServicesClusterHealth SolutionsRemote OpportunitySome of the timeLocation - CountrySouth AfricaLocation - ProvinceGautengLocation - Town / CityCenturionIntroduction Metropolitan is one of the oldest financial services brands in South Africa. With...

  • Claims Assessor

    3 weeks ago


    Centurion, South Africa Momentum Life Full time

    **Introduction** The Retail Life Insurance department is looking for a self-driven, dynamic health professional who wants to grow their career in Claims Assessment. Myriad is Momentum's market-leading life insurance product, providing lifecover to clients in South Africa. Our Myriad product aim in partnering with our clients on their journey to success. We...

  • Claims Assessor

    2 weeks ago


    Centurion, Gauteng, South Africa Momentum Life Full time

    IntroductionRole Purpose**- To be part of a team that provides market leading claims assessment capability for living benefits (critical illness, income and disability benefits). This will include specialising in income disability, lump sum disability,critical illness and case management for living benefits, the completion of quality industry assessments...


  • Centurion, Gauteng, South Africa OUTsurance Full time

    Company DescriptionOUTsurance is a world-class, fast growing short-term & life insurer based in Centurion. You always get something OUT, in that we are vibrant, successful and values orientated with an awesome dynamic culture that aligns its business with its core values of Awesome service, Passionate, Honest, Human, Dynamic and Recognition. A Desktop...

  • Claims Consultant

    3 weeks ago


    Centurion, South Africa PSG Insure Full time

    **Job description**: The Claims Consultant is responsible for coordinating and overseeing, managing and negotiating the settlement of the claim. The consultant is accountable for finalising the claim end-to-end and must have knowledge of Commercial and Personal lines products and be able to process motor as well as non-motor claims **Responsibilities**: -...

  • Claims Assessor X2

    4 days ago


    Centurion, South Africa Health Solutions Full time

    **Introduction** Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by...

  • Claims Assessor X2

    3 days ago


    Centurion, South Africa Health Solutions Full time

    **Introduction** Momentum Health Solutions, anentity of MomentumMetropolitan Holdings deliverssustainable, integrated healthsolutions that meet the needs ofclients in the different segmentsand maximise lifetime clientvalue. We build and maintain aculture of innovation, and createvalue through unique insights ofhow to achieve specificoutcomes by using a...

  • Claims Assessor X2

    2 weeks ago


    Centurion, Gauteng, South Africa Health Solutions Full time

    IntroductionMomentum Health Solutions, anentity of MomentumMetropolitan Holdings deliverssustainable, integrated healthsolutions that meet the needs ofclients in the different segmentsand maximise lifetime clientvalue. We build and maintain aculture of innovation, and createvalue through unique insights ofhow to achieve specificoutcomes by using a defined...

  • Death Claims Assessor

    2 weeks ago


    Centurion, South Africa Momentum Life Full time

    **Introduction**Role Purpose** - To provide specialist and accurate death benefit claim decisions, through assessing client’s information as well as medical information aligned to the product and policy agreement.**Requirements**: - Matric - Relevant business-related qualification. - Relevant Insurance/Financial services Industry, applicable regulatory...

  • Claims Administrator

    2 weeks ago


    Centurion, Gauteng, South Africa PSG Insure Full time

    Job description:The Claims Administrator is responsible for coordinating and overseeing, managing, negotiating settlement of the claim and is accountable for the finalisation of the claim end-to-end.Responsibilities: Register claims and appoint assessors Manage claims in terms of claims SLA Make decision regarding merit indemnify or not Negotiate settlement...

  • Ip Claims Assessor

    3 weeks ago


    Centurion, South Africa Momentum Life Full time

    **Introduction** The Retail Life Insurance department is looking for a self-driven, dynamic health professional who wants to grow their career in Claims Assessment. Myriad is Momentum's market-leading life insurance product, providing life cover to clients in South Africa. Our Myriad product aim in partnering with our clients on their journey to success. We...

  • Claims Consultant

    3 weeks ago


    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** Our consultants...