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  • Posted: Jan 26, 2021
    Deadline: Not specified
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    Since our establishment in 1918, Sanlam has been a prominent part of the South African business landscape. We have always held a long-term view of how business adapts to the demands of the environment in which it operates. Today, in a dynamic world, we see an evolving set of social, economic, political and environmental imperatives that require our skilfu...
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    Claims Assessor X4 ( Fixed Term Contract)

    Sanlam Developing Markets (SDM) (a wholly-owned subsidiary of Sanlam Life Limited) is one of the top financial services providers in the South African entry-level and emerging middle market. It aims to understand the unique requirements of clients and offers a wide range of simple and affordable financial solutions that cover needs such as funeral insurance, savings for education, life cover and personal accident plans. In terms of the Sanlam Group Governance Policy, SDM is managed by the SA Retail Mass cluster, which is part of the Sanlam Life and Savings cluster within the Sanlam Group. There are four businesses within the SA Retail Mass cluster, namely; Group Benefits, Individual Life, Safrican Insurance and African Rainbow Life.

    What will you do?

    • Full processing and following up of all Group Benefit claims within the required SLA
    • Processing 15 claims per day
    • Launching claims on the system
    • Provide feedback to clients on finalisation of claims (email and telephonic communication)
    • Ensure that all criteria is met to pay valid claims, and invalid claims are repudiated (Ensure the proper processes are followed and that it is of high quality)
    • Ensure that clients are provided with real time information on the status of the claims and policy changes, in line with Treating Clients Fairly policy of Sanlam and Legislation
    • Daily follow-ups on pending claims
    • Drafting proof of payment letters
    • Drafting of repudiation letters
    • Ensure that 100% of work is accurately processed within agreed SLA
    • Ensure that work complies with set standards (100% interactions logged timeously and accurately on GAP and Pavlov
    • Adherence to all Standard Operating Procedures related to the role
    • Assisting with adhoc projects
    • Processing of paid-up claims and submission of certificates
    • Updating registers and other management reporting
    • Adherence to Product Specifications and underlying policy terms and conditions
    • Adherence all relevant internal policies and procedure
    • Assist other operational areas as and when required

    What will make you successful in this role?

    Qualification & Experience

    • Matric
    • At least 2 years’ experience in an insurance claims environment
    • At least 6 months experience interacting with clients telephonically
    • COP is an advantage

    Knowledge And Skills

    • Computer literacy
    • MS Office, proficient in excel
    • Basic Insurance understanding
    • Be able to speak English, and understand a second Language
    • A good understanding of the TCF principles as well as the Policyholder Protection Rules

    Method of Application

    Interested and qualified? Go to Sanlam Group on careers.sanlamcloud.co.za to apply

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