South Africa: Administrator: IL Claims Assessment (Insurance) posted by AtripleA recruitment & temps
Posted on 2025-04-29 00:00:00
| Employer | AtripleA recruitment & temps |
|---|---|
| Category | Other Insurance |
| Location | South Africa / South Africa |
Job Summary
Location: Pretoria, South Africa
Salary: R19 800 – R22 000
Our client in the Insurance industry is looking for an Administrator: IL Claims Assessment.
Key responsibilities
- 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
- 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
- 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 *****@*****.co.za
ATripleA Recruitment and Temps
www.********.co.za
Click Go Apply to apply online!
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