Claims Administrator at Discovery Limited

Key Purpose

• The position is responsible for the day-to-day administration and managing a small team within Group Life Operations. This is a core administration function and the incumbent would be required to holistically manage and control a portfolio of different Group Life disciplines, for example monthly contribution, claim, investment option, individual transfer in, section 14, section 28 processes. The incumbent must ensure that processes and procedures are implemented, maintained and improved. The incumbent needs to ensure operational activity is conducted within regulatory frameworks, accurately, effectively and efficiently. The incumbent must ensure that he/she has the knowledge, skills, tools and competencies required to perform the required job within service level agreements. The incumbent must have an appetite to be part of a growing new business unit, continuous improvement, able to adapt to change easily and play a role in change management within the team, challenge the status quo, inspire and motivate others. The incumbent will continually review existing processes and procedures in order to ensure the delivery of committed services to the Group Life Clients.

Areas of responsibility may include but not limited to

• Prepare monthly claim reports
• Analyse the claim reports and query where necessary
• Liaise with the Administration department to confirm sum assureds, credit control and member covers.
• Handle claim related queries as well as assist with Call Centre overflow.
• Drafting of letters as and when required
• Investigate and resolve actuarial queries.
• Register data checks daily and monthly.
• Investigate reason for query.
• Maintain and have records updated.
• Request for various data from the systems and business areas.
• Collate and compare data.
• Daily reporting.
• Daily comparisons between various system extracts ( cognos, register extract, paradigm extracts, payments etc).
• Daily summary findings based on the comparisons.
• Resolutions to summary findings.
• Resolution of actuarial data queries within a short timeframe.
• Resolution of register data queries within a short timeframe.
• Follow up on outstanding data query resolution.
• Provide regular status updates.
• Daily register validation checks.
• Maintain, death, funeral and disability payment registers.
• Process Ad-hoc payments as and when required.
• Partake in adhoc projects/tasks assigned by Management.

Personal Attributes

• Leading and Supervising
• Planning & Organizing skills
• Working with People - Communication
• Persuading and Influencing
• Adhering to Principles and Values – Self management
• Delivering Results and Meeting Customer Expectations
• Coping with Pressure and Setbacks
• Relating and Networking
• Teamwork and analytical skills
• Communication
• Problem solving
• Initiative and enterprise
• Learning
• Technology

Education and Experience

• Grade 12 and further studies are advantageous.
• Telephone etiquette, detail orientated and self-driven.  
• Customer centric focus to be evident.
• MS Office; Compass
• 3 – 5 years claims experience in the long term insurance industry. 
• Pension and Provident Fund experience is advantageous.