Job Description
Position: Claims Assessor  Individual Life Benefits
Location: Sandton 
Industry: Long-Term Insurance | Banking Client
Are you a detail-oriented professional with a passion for precision, service excellence, and impactful decision-making? Our client, a leading name in the banking and insurance space, is looking for a Claims Assessor to join their high-performing team. If you thrive in a fast-paced environment and have a knack for interpreting complex medical and legal information, this is your moment to shine.
What Youll Be Doing:
Assess productivity targets  average of 7 benefits per day per individual
Deliver exceptional service through formal, standards-driven communication
Independently assess claims within authority limits to ensure accuracy and minimize error rates
Uphold service level agreements to maintain operational excellence
Achieve Quality Assurance scores above 85% for claims decisions and communication
Present complex claims (disputes, declines, voids) to cross-functional committees including medical, legal, underwriting, actuarial, and compliance
What You Bring:
Experience:
 35 years in Claims Assessment (Death, Disability, Severe Illness)  Essential
 23 years in Underwriting  Advantageous
Understanding medical codes
Education & Registration:
 Matric  Essential
 Diploma/Bachelors in Nursing, Occupational Therapy, or Physiotherapy  Essential
 35 years of relevant claims experience, long term insurance 
Skills:
 Analytical thinking 
 Communication 
 Decision-making
 Attention to detail 
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