Life Claims Adjudicator

3 weeks ago


Johannesburg CBD, South Africa Rand Mutual Admin Services Full time
Job Title: Life Claims Assessor

At Rand Mutual Admin Services, we are seeking a highly skilled and experienced Life Claims Assessor to join our team.

Key Responsibilities:
  • Adjudicate and process claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance.
  • Verify claims captured for correctness and compliance, and capture/accept additional information on claims as required.
  • Manage claims in line with individual targets, reviewing claims in line with process, authority limits, and within agreed timelines.
  • Communicate claims process to both the employer and employee as set out in the claims management processes.
  • Adjudicate and process payments for claims, including adjudication and processing of TTD benefits and sundry invoices within authority limits.
  • Manage medical reports for claims with Permanent Disability, and provide customers with accurate product and service information in an efficient manner.
Requirements:
  • Matric
  • FAIS Regulatory Examination (RE5)
  • NQF Level 5 Higher Certificate in a FAIS Recognised Qualification
  • A medical qualification would be advantageous
  • Insurance Qualification (advantageous)
  • 3 to 5 years claims related experience
  • General knowledge of the LTI Act
  • Intimate knowledge of the FAIS Act
  • Intimate knowledge of the GCOC
  • Intimate knowledge of the Insurance Act
  • General knowledge of the ASISA Standards and Guides
  • Good Administrative skills
  • Advanced Excel Skills
What You'll Get in Return:

We offer great opportunities for personal and professional development in a stable company that's 130 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office) are also available.

You will be a part of a dedicated group of colleagues who value teamwork and collaboration. Our commitment to transformation is also evident in our employment equity plan, which may give preference to candidates from under-represented designated groups.



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