Claim Assessor: MiWayLife : Parktown, Gauteng at Sanlam Group

What will you do?

• This is a specialist position that reports directly to Operations Manager : Claims. The role is accountable for the execution of a compliant and effective claims administration function for both underwritten lives and simple funeral claims.

Key responsibilities include:

• Assess and execute Life and Funeral claims. 
• Undertake the full process of administrating a Life/Funeral claim from receipt to payment.
• Build relationships with external partners in getting claims information and expatiating claim settlements.

What will make you successful in this role? 

• Analytical and detail minded
• Curious and investigating orientation
• Sound ethics
• Client orientated 
• Financial acumen
• Problem solver
• Good communicator/confident
• Able to build relationships/partnerships
• Planning and organising orientation 
• Quality orientation

Qualification & experience 

• Grade 12 and a medical or nursing qualification
• Experience in financial distribution services, preferably reinsurance
• Minimum 2 years of experience in claims assessment
• Assessor certification will be advantageous.
• Medical background experience 

Knowledge and skills 
IT:

• MS: Office (Excel, Word, PP, Outlook)
• MIS
• CRM tools

Business:

• Financial services industry knowledge 
• MiWayLife business and operating model 
• Financial services product knowledge (MiWayLife)
• Relevant regulatory legislation and compliance knowledge 
• Policy contracts governances, clauses, cover
• Claims and assessor principles, processes, and governances 
• Underwriting processes and guiding principles (basic) 
• Medical/health assessment indicators and metrics
• Call centre and sales processes
• Client complaints processes

Qualification and Experience

• Grade 12 with up to 3 years related experience.

Knowledge and Skills

• Assists with claims administration
• Assists with claims settlement proposals
• Operate within claims guidelines and compliance