Claims Assessor

3 days ago


Bellville, South Africa Momentum Metropolitan Holdings Full time

-Introduction

Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations.
Role Purpose

The purpose of this role is to prepare and recommend payments in line with the claims philosophy.
Requirements
- Matric / Grade 12 with Maths and / or Accounting
- 2 years claims experience in death, disability and / or maturity experience
- Understanding of long term insurance industry and In House systems
- Knowledge and understanding of Insurance Legislation, Pension Fund Act and TCF
- Knowledge and understanding of claims assessment philosophy and medical underwriting
Duties & Responsibilities
- Strive to finalise claims as soon as possible and with the minimum requirements
- Assess, quality control and recommend the payment of claims
- Monitor and manage the adherence to the service level agreements for customer service
- Answer all claims related queries telephonically and in writing
- Assist with identified projects
- Investigate client queries within the agreed service level and ensure that client receives timeous feedback;
- Escalate client queries to the relevant department or stakeholder;
- Provide accurate information and advice to clients and stakeholders in order to ensure that the client receives the appropriate after sales services;
- Provide authoritative, expertise and advice to clients and stakeholders.
Competencies
- Business Acumen
- Customer/ Stakeholder Commitment
- Drive for results
- Leads Changes and Innovation
- Collaboration
- Impact and influence
- Self-Awareness and Insight
- Diversity and Inclusiveness

Policy

We are committed to Employment Equity, diversity and inclusion when recruiting internally and externally. All appointments are made in alignment to our Employment Equity goals and we encourage people with disabilities to apply.



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