THE JOB AT A GLANCE As a Life Claims Assessor, you will be reporting to the Claims Manager: Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. WHAT WILL YOU DO? Claims Adjudication: § Verify claims captured for correctness and compliance § Capture / accept additional information on claims i.e. medical reports § Ensure all documents required to process a claim are indexed and filed into the system § Add meaningful and accurate notes to ensure complete synopsis of claim on the system § Update requirements on claims and ensure they are always accurate and up to date Claims Management: § Manage claims in line with individual targets § Review of claims in line with process, authority limits and within agreed timelines § Escalate where required within authority limits § Management of medical reports for claims with Permanent Disability § Communicate claims process to both the employer and employee as set out in the claims management processes § Timeous management of workflows and notifications Adjudicate and process payments for claims: § Adjudication and processing of TTD benefits including approval within authority limits § Adjudicating and processing payment of sundry invoices within authority limits § Process Permanent Disability claims Customer Service: § Regularly communicate and liaise verbally and in writing with customers/suppliers/visitors/enquirers and relevant staff § Interpret and respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions § Manage walk-in queries as and when required in line with the RMA Service Catalogue § Handle customer inquiries both telephonically and by email § Research required information using available resources § Provide customers with accurate product and service information in an efficient manner § Update existing customer personal information on the system § Deal with all customers in a professional and empathetic manner WHAT WILL YOU GET IN RETURN? We offer great opportunities for personal and professional development in a stable company thats 130 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration. Turnaround time The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. Kindly note that should you not receive a response within 21 days please consider your application unsuccessful. Our Commitment to transformation: In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets, preference may be given, but is not limited, to candidates from under-represented designated groups. WHAT YOU'LL BRING TO THE TABLE? § Grade 12 qualification/Matric Certificate § FAIS Regulatory Examination (RE5) Certificate § NQF Level 5 Higher Certificate in a FAIS Recognised Qualification § A medical qualification (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 § Knowledge of Claims processing, approval § Long Term Insurance experience § Deadline driven
