Claims Consultant

2 weeks ago

Cape Town, South Africa RGA Full time

**Position Overview**
The Claims Consultant assesses and manages claims effectively and efficiently, within the required SLA, ensuring optimal profitability of the business.
**Responsibilities**
- Claims assessment and management of Individual Life claims across all benefit types, for the South African operation, as well as other benefits relevant to the business (e.g., credit life, funeral).
- Provide quality technical support and training to clients.
- Proactive case management of disability income claims.
- Assist with client audits where required.
- Identify trends and report to Head of Claims.
- Assist with developing and delivering claims value-added solutions to clients.
- Identify fraud, waste and abuse and act in accordance with internal orocesses.

**Requirements**:
Required:

- At least 3 years assessment experience of all major benefit types in the Individual Life sector.
- At least 2 years assessment experience of credit life and funeral claims.
- Degree in Occupational Therapy or Physiotherapy or any other relevant qualification.
- At least 3 years clinical experience in their field.
- Medical and functional knowledge that can be applied in an insurance setting.
- Computer literate and proficient in Microsoft Office.
- Flexibility to handle diverse tasks in a fast-paced environment.
- Innovative problem-solving ability.
- Client-centric approach with strong networking skills.

Preferred:

- Understanding of current industry trends and legislation, impacting life insurance and claims.
- Knowledge of the Ombudsman process and dealing with complaints.
- Ability to view the bigger picture and impact on the business.
- Ability to transfer knowledge to others.
- Good presentation skills.

Job Reference: SA00364

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