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Strategic Personnel

Claims Consultant Life

Strategic Personnel

  • R24,000 - R30,000 per month
  • Permanent Intermediate position
  • South Africa
  • Posted 22 May 2024 by Strategic Personnel
  • Job 2569339 - Ref JHB000564

About the position

The purpose of this role is responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims.

Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge and experience to make appropriate and accurate decisions on claims worked on.

Assessment of income, disability and critical illness claims following policy terms and claims philosophy as well as facilitate case management programmes where applicable to assist claimants in their return to work
Your qualifications:
- Grade 12 (Essential)
- Relevant tertiary qualification; a medical degree preferable

Your Outputs (include but is not limited to):
- Evaluate claims forms and supporting documentation in preparation of making an payment decision
- Gathering information and various types of reports from medical practitioners
- Compare the reports to the existing claims criteria to establish if claim is payable
- Decide on levels of provisions to be raised based on information received
- Writing claims assessment standards/policies
- Auditing/QA of work done by peers
- Deliver claims payment decision
- Determine requirements / documents required to evaluate claims
- Liaise with relevant re-insurers to determine validity of claims and get their approvals where required
- Explain and communicate final decisions to brokers and clients
- Create schedules for payments and obtain relevant approvals

Your experience:
- Minimum 2-3 years experience in Life Insurance Assessing
- Medical Background
- Experience in both group and life individual life claims (Essential)
- Sound Business and Operational knowledge of Insurance Industry administrative processes
- Good knowledge of the business administration platforms
- Familiar with Compliance Processes and Procedures in the Insurance Industry
- Familiar with the business products and their rules and workings
- Familiar with the business products and their rules and workings

Your skills and character traits:
- MS Office and PC literate
- Accurate Typing Skills
- Excellent verbal and written communication skills
- Quality driven
- Ability to pay attention to detail as accuracy is important
- Using effective interpersonal skills to resolve conflict situations
- Ability to work effectively with others and contribute to team task accomplishment
- Ability to multi-task and manage multiple priorities
- Have the ability to operate effectively under pressure
- Task and deadline orientated
- Analytical mind and above average problem solving techniques
- Strong sense of ownership
- Pro-active and innovative

EXCELLENT GROWTH OPPORTUNITIES

Desired Skills:

  • Individual Life Claims
  • Medical assessing
  • Medical claims (Life)
  • Evaluate claims
  • Group claims

Employer & Job Benefits:

  • Performance incentive monthly 30 %

Strategic Personnel

About the agency

Established in 1994, Strategic Personnel is a specialist, dynamic recruitment agency focussing on the recruitment of senior executive, middle and junior management and office support staff. Strategic Personnel's focus is in the sectors of Banking, Financial Services, Human Resources, Legal, Marketing and other Professional sectors. Strategic Personnel counts as our clients the large Banking and Merchant banking groups, Insurance houses and many of the Top 100 companies listed on the JSE. Strategic Personnel prides ourselves in a strong understanding of our core business and the fact that every candidate and client is unique. Our established and succesful track record is your guarantee of a company proud to offer knowledgeable staffing solutions to match your individual needs.

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Job expired on 2024/05/30

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