Benefits Claims Specialist
4 days ago
Oxyon People Solutions
In this role as Service Consultant – Unclaimed Benefits, you will be responsible for assessing, validating, and processing payment of all unclaimed benefit cases within legislation, fund rules, and policy guidelines. As a key member of the team, you will promote fund objectives and service excellence in all claim-related functions.
Main Responsibilities:
- Review applications/claims received for all unclaimed benefits, ensuring that all supporting documentation is attached as required.
- Assess death claims and draft comprehensive death claims reports in line with Section 37C stipulations.
- Action payment of all claims within agreed SLAs, mitigating payment risks and escalating cases where necessary.
- Compile clear claims communication, sending out acknowledgement notices within 24 hours and keeping clients/claimants informed throughout the claims process.
- Maintain standards in accordance with processes, procedures, administration agreements, regulatory requirements, and service level agreements.
- Prepare daily stats reports and distribute accordingly, as well as prepare claims data and report to the admin team on request.
- Liaise with employers, members, beneficiaries, and internal specialist departments through correspondence, telephone, and email.
- Maintain and update workflow systems and prescribed daily production stats, participating in various meetings and contributing to discussions and decisions from a servicing strategy perspective.
- Resolve queries and complaints within SLA, assisting with project work for the operational team when required, and incident reporting and escalation.
Requirements:
- Strong analytical and problem-solving skills, with attention to detail and accuracy.
- Excellent communication and interpersonal skills, with the ability to build strong relationships with stakeholders.
- Ability to work independently and as part of a team, with a focus on delivering high-quality results under pressure.
- Proven experience in claims processing or a related field, with knowledge of relevant legislation and fund rules.
About Oxyon People Solutions
We are a leading provider of recruitment and HR services, committed to helping businesses succeed through our expertise and passion for people. Our goal is to deliver exceptional results, building long-term relationships with our clients and candidates.
Salary: The estimated salary for this role is $65,000 - $80,000 per annum, depending on location and experience.
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