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Pretoria
Administrator
19800

Our client in the Insurance industry is looking for an Administrator: IL Claims Assessment.

 

Key responsibilities 

 

1.     Assessing and processing of life and funeral claims

·        Process funeral and life claims and prepare for claims approval process within 48hrs of receipt 

·        Verify premiums paid on the system prior to assessing claims 

·        Verify deceased and beneficiaries against main policy on the system 

·        Confirm the policy holders relationship to the deceased 

·        Liaise with Re-insurers where necessary on Life cover policies below R300 000.00 

·        Refer suspicious fraudulent claims to Specialist administrator 

·        Discuss complex claims with in-house professional advisor and consultants 

·        Follow up timeously on all outstanding claims 

·        Liaise with relevant stakeholders on outstanding and incorrect Id numbers and where the person is covered on the application form but does not exist on the system 

·        Liaise with Client services where the deceased died before the policy become inactive. To activate the policy prior to assessing 

·        Responsible for identifying disputes and complaints of complex claims 

·        Recommend a solution to Senior Manager where claim arises a day before the 6 month waiting period expires 

·        Update AIMS notes on system 

·        Be a 2nd validator on captured and authorized claims 

·        Give feedback on follow-up claims to Section leader  

·        Forward a spread sheet of all finalized claims to Section Leader

 

2.     Claims pay-out

·        Confirm status of the claim if it is approved or declined 

·        Where the age of the deceased differ with the one on the system apply the penalty formula 

·        Recommend decline/payment of claims 

·        Double check the consistency on banking details attached to the claim and the one on the system 

·        Forward the claim to Manager for payment 

·        Check the finance list and sign off

 

3.     Reconcile information received, processed and finalized

·        Compile monthly individual statistics 

·        Compiling all branch registers month end (Death) 

·        Present challenges experienced and solutions taken to resolve them

 

Requirements                                          

·        Matric 

·        NQF 4 in Insurance (Advantage)

·        2 years life insurance in claims

·        Intermediate MS Office Word, Excel, PowerPoint

 

Send your CV and latest pay slip to raca@aaaa.co.za

ATripleA Recruitment and Temps

www.aaaa.co.za

#atriplea #recruitment #vacancy #administration

Posted 2024-05-15

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