Job Description
Sector: Insurance
Location: Pretoria
Salary: R900 000 (negotiable)
Our client in the insurance sector is looking for a Claims Administrator to monitor the management of individual life claims administration.
Duties:
• Monitor management of claims administration on individual life policies
• Design and develop standard operating procedures
• Oversee the management of efficient and effective administration of claims
• Align Branch Office procedures with Head Office procedures
• Monitor processes and procedures for the detection of fraud activities on claims
• Provide inputs to forensics, IT department and external fraud forum
• Decide and discuss dispute claims
• Decide on ex-gratia payments in agreement with Senior Executive Manager
• Monitor payment turn-around time of finalized
• Sign-off finalized approved claims payments
• Co-ordinate complaints resolution and compliance
• Provide inputs into strategy
• Management of implementation of claims workflow and audits
• Conduct claims audits at branches to comply with claims rules and procedures
• Manage implementation of processes that are followed and completed for audits
• Monitor completion and updates of loss/near loss register
• Provide feedback on processes to auditors
• Provide feedback to auditors on steps taken to ensure claims are paid correctly
• Provide feedback to Risk Manager
• Design and develop processes for unclaimed assets
• Align unclaimed assets with claims rules and process
• Obtain an external service provider to trace the policy holders
• Attend the unclaimed asset committee meetings
• Chair unclaimed assets committee and align with requirements
• Report on IL Claims Administration
Requirements:
• Degree: Risk Management/Business Management/relevant
• RE1 & RE 5
• Registration as a Key Individual
• 60 or 120 credits on NQF level 5 (Depending on the date of appointment in the industry)
• 5 Years’ Experience in long term insurance claims
• At least 5-8 years in Management
Send your CV and latest pay slip to *****@*****.co.za
AtripleA Recruitment and Temps
www.********.co.za
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