Claims Specialist at Sanlam Group

Who are we?

MWL is dedicated to supporting, growing and empowering clients with affordable, simple, and suitable solutions, primarily through telephonic intermediary channels. We have approximately 120 tied advisors, all dedicated to meeting the financial needs of our clients and prospective clients.

MiWayLife’s vision is to establish a world-class direct financial service business that seeks to:

• offer its clients excellent service, superior value products, and fair treatment always;

• be an employer of choice; and

• be a good corporate citizen and play a meaningful role in the transformation of the Financial Services industry.

MiWayLife’s culture is values-based and is built around the pillars of Accountability, Attitude, Energy Freedom and Professionalism. We are a family of vibrant and energetic free-thinkers, constantly looking to innovate and disrupt.

What will you do?

This is a specialist administration position that reports directly to the Head of Claims and Underwriting. The role is responsible for supporting the claims department in, tracking claims workflow and tasks, including tracking of outstanding requirements in collaboration with Assessors, and updating/monitoring the claims register to ensure accurate MIS and that claims are processed as quickly as possible for clients.  

Key responsibilities include;

• Understand the claims notification, assessment, decisioning (outcomes) and payment processes, steps and requirements.

• Take note of all new claims (notified) being received from Service Dept for processing by Assessors

• Work actively (daily) on the Claims Register to track the status and flow of all steps required by Assessors in finalising claims including;

               a.    Check that all new claims are updated on the register, and TE system.  Verification of client/policy
               b.    Track the submission of client information and claims related documentation.
               c.    Monitor stages and associated steps of the claim processing including; 

• • • Fulfilment: assessment, capturing, early knock off, claims committee decisions, underwriting investigation, payment

• For all the above check that actions and feedback have been updated on Claims Register

• Draw daily reports (i.e.: TE) to check new cases, as well as do evaluation on the status of cases for all Assessors as per the processes above

• Remind and encourage progress by compiling and sending emails/phone to all Assessors on un-updated fields, overdue documentation, unattended claims.  Request feedback.  Record feedback for follow-up.

• Work closely/feedback to the Claims Team Leader and Head of Claims and Underwriting to :

                a.    flag specific problems that need to be escalated for action. 
                b.    Identify trends and patterns that need to be addressed upon to improve the overall claims process

• Liaise and communicate claims related updates to Re-insurer.  

 

Outsourced claims service providers:

• Communicate, support and co-ordinate with external claims service providers processing claims for MiWayLife.  

• Track/evaluate the progress of outsourced claims, follow up/feedback as required.

• Update Claims Register accordingly/integrate information for total claims ‘picture’.   

• Report as needed to management.

What will make you successful in this role?

Qualification & experience 

• Grade 12 

• Post 12-grade Qualification will be advantageous

• Experience in financial administration, preferably claims

 

Knowledge and skills 
IT:

• MS: Office (Excel~ advanced, Word, Outlook)

• Knowledge of Thought Express (TE) will be advantageous, but not a precondition.

Business:

• Financial services industry knowledge (basic)

• Financial services product knowledge (MiWayLife)~ (basic)

• Claims processes, assessor principles, governances/SLA’s 

• Underwriting processes and guiding principles (basic) 

Personal attributes 

• Quality orientation/attention to detail

• Curious and investigating orientation

• Problem solver

• Good communicator

• Able to work well within a team

• Planning and organising orientation 

• Action orientated

Qualification and Experience

Diploma or grade 12 with at least 4 to 5 years related experience.

Knowledge and Skills

• Claims administration
• Claims settlements of a complex nature
• Claims approvals and rejections
• Operate within claims guidelines and compliance
• Coach and mentor less experienced short term claims clerks

Personal Attributes

• Business insight - Contributing independently
• Manages complexity - Contributing independently
• Plans and aligns - Contributing independently
• Manages conflict - Contributing independently

Build a successful career with us

We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future – your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realize their worth. 

Core Competencies

• Cultivates innovation - Contributing independently
• Customer focus - Contributing independently
• Drives results - Contributing independently
• Collaborates - Contributing independently
• Being resilient - Contributing independently

Turnaround time

Due date for applications:  
The closing date for applications is 12 November 2021.

Please note that the recruiter reserves the right to withdraw the advertisement prior to the closing date, or to allow for further applications to be submitted after the closing date indicated.  

Turnaround times
The time taken to complete this process depends on how far you progress and the availability of managers.  
 

Our commitment to transformation

MiWayLife is committed to transformation and embracing diversity and our employment equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.