Description
THE JOB AT A GLANCE

• As a Life Claims Assessor, you will be reporting to the Partner Claims Specialist – Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance.

WHAT WILL YOU DO?

• Claims Adjudication:
• Verify claims captured for correctness and compliance
• Capture / accept additional information on claims i.e. medical reports
• Ensure all documents required to process a claim are indexed and filed into the system
• Add meaningful and accurate notes to ensure complete synopsis of claim on the system
• Update requirements on claims and ensure they are always accurate and up to date
• Claims Management:
• Manage claims in line with individual targets
• Review of claims in line with process, authority limits and within agreed timelines
• Escalate where required within authority limits
• Management of medical reports for claims with Permanent Disability
• Communicate claims process to both the employer and employee as set out in the claim’s management processes
• Timeous management of workflows and notifications
• Adjudicate and process payments for claims:
• Adjudication and processing of TTD benefits including approval within authority limits
• Adjudicating and processing payment of sundry invoices within authority limits
• Process Permanent Disability claims
• Customer Service:
• Regularly communicate and liaise verbally and in writing with customers/suppliers/visitors/enquirers and relevant staff
• Interpret and respond clearly and effectively to spoken requests over the phone or in person, and to verbal or written instructions
• Manage walk-in queries as and when required in line with the RMA Service Catalogue
• Handle customer inquiries both telephonically and by email
• Research required information using available resources
• Provide customers with accurate product and service information in an efficient manner
• Update existing customer personal information on the system
• Deal with all customers in a professional and empathetic manner