Claims Consultant

Wholl you report to:

Youll be based at our head office in Sandton, Johannesburg. Youll report to the Team Leader: Claims

Assessing responsible for Claims.

Your qualifications:

Grade 12 (Essential)

Relevant tertiary qualification; a medical degree preferable

Your Outputs (include but is not limited to):

Evaluate claims forms and supporting documentation in preparation of making an payment

decision

Gathering information and various types of reports from medical practitioners

Compare the reorts to our exisitng 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 requirments / documents required to evaluate claims

Liase 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

Your experience:

Minimum 2-3 years experience in Life Insurance Assessing

Medical Background

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