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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