Claims Assessor

2 weeks ago

Johannesburg, South Africa Sanlam Full time

Who are we?
Sanlam Developing Markets [SDM] (a wholly-owned subsidiary of Sanlam Life Limited) is one of the top financial services providers in the South African entry-level and emerging middle market. It aims to understand the unique requirements of clients and offers a wide range of simple and affordable financial solutions that cover needs such as funeral insurance, savings for education, life cover and personal accident plans. In terms of the Sanlam Group Governance Policy, SDM is managed by the SA Retail Mass cluster, which is part of the Sanlam Life and Savings cluster within the Sanlam Group. The cluster focusses on retail products, as well as group schemes. What will you do?
To assess each claim on the claim administration system and identify the type of claim
Assess the validity of the identified claim by assuring all the supporting documentation has been submitted. (assess the documentation in terms of signed claim form, id of deceased, proof of bank details, death certificate, BI 1663)
Valid claims are processes on the administration system and send for payment

**Claims that have outstanding documentation**: client will be notified of outstanding requirement
Invalid claims will be rejected/ Repudiated
All claims processes must align to SLA and SOPS
To maintain and error rating of less than 1 %
Assure capturing of claims are done accurately
Assure all criteria is met to pay claim
Assure the quality of feedback (written and verbal) to clients
To ensure that clients are provided with real time information on the status of the claim (feedback on the claim processing)
Assure feedback on requirements for successful claims payment is done timeously
What will make you successful in this role?
Qualification & experience
Matric
1-year relevant experience in a similar environment essential
Knowledge and skills
Proficiency in MS Word & Excel (intermediate level) essential
Computer literate
Communications skills (written and verbal)
Personal Attributes
Attention to detail
Customer focused
Investigative
Interpersonal skills
Analytical skills
Build a successful career with us
We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future - your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realise their worth. Through its four business clusters - Sanlam Life and Savings, Sanlam Investment Group, Sanlam Emerging Markets, Santam, as well as MiWay and the Group Office - the group provides many opportunities for growth and development. Core Competencies Cultivates innovation - Contributing independently Customer focus - Contributing independently Drives results - Contributing independently Collaborates - Contributing independently Being resilient - Contributing independently Turnaround time
The Sanlam Group is committed to achieving transformation and embraces diversity. This commitment is what drives us to achieve a diverse, inclusive and equitable workplace as we believe that these are key components to ensuring a thriving and sustainable business in South Africa. The Group's Employment Equity plan and targets will be considered as part of the selection process.

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