Claims Assessor

Are you seeking a role within a leading (BPO) customer service solutions provider? Our Client is seeking a Claims Assessor who will be based in Durban. The purpose of the role is to be responsible for validating, evaluating, making the correct assessment decision and calculating the correct settlement for CPP (Life) Claims assessed.

Minimum Requirements

Matric.

Minimum Qualification: Relevant NQF 4.

A medical qualification would be an advantage.

Preferred Qualification: Further Education and Training Certificate (FETC) in Short Term Insurance, Long Term Insurance or Retail Insurance.

FAIS Regulatory Exam for Representatives (RE5).

At least 2 - 4 years work experience as a Life Assessor is required.

Key Duties

Claims Processing;

Confirm that the claim intimation is correct and valid.

Check the status of the policy & receipt of premium (current and up to date), to facilitate claim processing.

Responsible for ensuring that all the required supporting documentation is obtained to comprehensively assess the claim. If necessary, requesting the Claims Administrator to source outstanding documents.

Responsible for evaluating and assessing the claim as per the policy wording/requirements documented in the policy wording.

Administrative Duties;

Support all involved stakeholders with regard to claim queries.

Ensure that all interactions and developments are well documented on company inhouse systems.

Ensure optimal use of MOS to manage workload.

Responsible for generating payment requisitions to facilitate claim payments.

Customer Service;

Responsible for ensuring that the principles of TCF are embodied in the assessment process/decision.

Responsible for providing excellent service to policy holders and business partners in respect of Claims.

Excited to learn more? Apply online now via the button below. You will receive an email acknowledging receipt of your application and information on our process. Kindly note the closing date of 3 April 2024 . We look forward to reviewing your application.