Claims Auditor

Recruiter:

Kamo Placements

Job Ref:

JHB000868/m

Date posted:

Tuesday, March 29, 2022

Location:

Centurion, South Africa

Salary:

Annually

JOB SUMMARY:

To conduct regular audits which includes planning, implementation and reporting on audits for the various product lines as well administering the life insurance claims which includes, registering, assessing, negotiating and settlement of claims within company

JOB DESCRIPTION:

JOB DESCRIPTION

Audit Planning – audit scoping, sample preparation on working papers and conducting opening meetings, audit planning memorandum
Implementation – testing scoped work and challenge control design and effectiveness, keep evidence and manage time accordingly
Technical assessment of claim by checking the applicable cover, scheme and member details, eligibility, financial details
Assess and confirm the eligibility, authenticity and validity of all evidence submitted by clients
Acknowledge all information received and let the client know who the assessor is
Claims assessing and validation including settlement, rejection and repair within set SLA
Loss adjustment by correctly quantifying losses
Provides input into the development or changing of operations policies or drafting of new policies and/or claims control systems on request.
Consults existing control systems to determine components that can be utilised/amended in the required control system.

JOB REQUIREMENTS

Preferred Minimum Education and Experience

Commercial Degree (BCom/ Business Management/ Economics/ Law/ Risk Management)
3-5 years’ experience in short term and/or Life insurance claims negotiation and handling
3-5 years’ experience in short term and/or Life general insurance
3-5 years’ experience in claims handling and Auditing
3-5 years claims auditing experience of SLA partners, UMA’s and Binder Holders

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