Consultant: Pre-Assessment x6
2 weeks ago
- Jobs by Location
- Job by industries
Key Performance Areas
Pre-Assessment of prospective claims
- Record all the submitted documents for prospective claims.
- Determine the benefits and the products submitted based on the submitted documents.
- Assess the submitted documents to determine compliance as per defined processes and rules.
- Apply compliance and/ lodgement rules in pre assesing the prospective claim.
- Identify duplicate claims and linked claims.
- Examine the prescription of lodgement and apply prescription rules.
- Verify mortality with Home Affairs
- Communicate the assessment outcomes to the prospective claimants
Quality assurance
- Ensure that pre assessment processes are implemented and maintained at the highest standards
- Maintain the implementation an unusual occurrence procedures.
Administrative support
- Document the acknowledged claims.
- Deal with/and respond to correspondence.
- Produce documents, briefing papers, reports and presentations.
- Assist with typing and editing briefs, technical papers, letters to various parties, and memos.
Reporting
- Track and report against set objectives and targets.
- Report on emerging risks.
- Provide ad hoc reports on process improvement initiatives
Stakeholder management
- Maintain healthy relationships with all stakeholders.
- Follow up and feedback to all stakeholders to keep them updated on the status of a query.
- Respond to queries within the predefined turnaround times
Qualifications and Experience
- Bachelor’s Degree/Advanced Diploma in a related qualification
- Relevant 3 years’ experience in the Claims environment.
- Insurance jobs
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