Junior Claims Assessor at Rand Mutual - RMA

Job description

PURPOSE: To effectively and efficiently process and adjudicate Injury on Duty and Occupational Disease Claims, within the scope of the Compensation for Occupational Injuries and Diseases Act

JOB PROFILE

QUALIFICATIONS

• Grade 12 (Including maths / accounting and Biology)NQF Level 5 Qualification in Business Administration, Insurance or Finance
• A National Diploma or Degree added advantage
• Computer literacy: Intermediate MS Word, Excel and Outlook
• Certificate of Professionally in Insurance an advantage
• Knowledge of human Anatomy and Physiology

EXPERIENCE

2 to 3 years’ industry related experience

JOB COMPETENCIES:

• Good communication skills (verbal and written)
• Results driven
• Applied Learning
• Building Customer Loyalty
• Contributing to Team Success
• Managing Work (includes Time Management)
• Initiating Action
• Stress Tolerance
• Decision Making
• JOB SKILLS:
• Multilingual
• Excellent Keyboard skills
• Good Administrative skills
• Ability to work under pressure,

CERTIFICATES:

COIDA in Practice or Insurance Qualification an advantage

AREAS OF RESPONSIBILITY

• Data Capturing
• Claims Management – 50 new claims per month (minimum)
• Management of minor injury claims
• Follow up on outstanding document required to determine RMA liability
• Review of claims where estimates are R1 to R100 000
• Ensure all scanned documents have been indexed correctly
• Process indexed documents timeously
• Management of Claims notifications
• Finalising claims within RMA’s Maximum medical improvement period
• Liaison with claimants, employers and medical service providers to secure outstanding information/documents
• Ensuring that quality of work is highest standard
• Adherence to Company Standard Operating Procedures