Risk Consultant: Individual Life Claims

Recruiter:

Moving Heads Personnel CC

Job Ref:

Risk Cons

Date posted:

Thursday, January 28, 2021

Location:

Johannesburg, South Africa

Salary:

neg.

SUMMARY:
Risk Consultant: Individual Life Claims

POSITION INFO:

Risk Consultant: Individual Life Claims

Sandton

R20 000 – R28 000 pm

Drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims.

Provide feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge and experience to make appropriate and accurate decisions on claims worked on.

Assessment of income, disability and critical illness claims following policy terms and claims philosophy as well as facilitate case management programmes where applicable to assist claimants in their return to work.

Evaluate claims forms and supporting documentation in preparation of making a payment decision

Gathering information and various types of reports from medical practitioners

Compare the reports to existing claims criteria to establish if claim is payable

Decide on levels of provisions to be raised based on information received

Writing claims assessment standards/policies

Auditing/QA of work done by peers

Deliver claims payment decision

Determine requirements / documents required to evaluate claims

Liaise with relevant re-insurers to determine validity of claims and get their approvals where required

Explain and communicate final decisions to brokers and clients

Create schedules for payments and obtain relevant approvals

MS Office

Accurate typing skills

Excellent verbal and written communication skills

Qualification:

Grade 12 (Essential)

Relevant tertiary qualification; a medical degree preferable

Minimum 2-3 years experience as a claims assessor

Experience in both group and life individual life claims (Essential)

Sound Business and Operational knowledge of Insurance Industry administrative processes

Good knowledge of the business administration platforms

Familiar with Compliance Processes and Procedures in the Insurance Industry

Familiar with the business products and their rules and workings

NB! This job is now closed. You can apply for other jobs by uploading your CV.

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