Senior Claims Specialist

3 weeks ago


Johannesburg CBD, South Africa Rand Mutual Admin Services Full time

Job Title: Senior Claims Assessor

Job Summary:

We are seeking a highly skilled Senior Claims Assessor to join our team at Rand Mutual Admin Services. As a Senior Claims Assessor, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance.

Key Responsibilities:

  • Adjudicate on claims: Adjudicate claims in line with relevant policies, terms and conditions and all other requirements
  • Decide on liability to pay the claims: Evaluate claims received and determine requirements i.e. medical reports, Statement of Earnings for adjudication
  • Manage claims: Manage claims in line with individual targets, review claims in line with processes and limits as set out in RMA guidelines, escalate claims out of defined authority limits to Team Leader
  • Manage Costs: Approve claims for payment within authority limits for Total Temporary Disablement and Permanent Disability lumpsums and where necessary refer to Team Leaders
  • Customer Service: Regularly communicate and liaise verbally and in writing with customers/suppliers/visitors/enquirers and relevant staff

Requirements:

  • NQF Level 6 Diploma in a FAIS Recognised Qualification
  • COIDA in Practice or Insurance Qualification an advantage
  • Legal qualification an advantage
  • FAIS Regulatory Examination (RE5)
  • Minimum 5 years experience within the Insurance industry within a claims environment

What You'll Get in Return:

We offer great opportunities for personal and professional development in a stable company that is 130 years strong. The role comes with a competitive salary package and various benefits.



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