Claims Processor (Insurance)

Clerk: IL Claims Processor_Temporary Assignment

Location: Pretoria

Salary: R36 p.h

Our client in the long term insurance industry in seeking a Claims Processor to process withdrawals and maturity claims.

Responsibilities:

1. Processing of investment claims:
• Check if the claimant is a correct claimant on the policy
• Check if the policy is due to be paid on the particular month
• Verify if all premiums where received
• Processing maturity, cash provider, cash back, school fund claims within 48hrs of receipt
• Prepare for claims approval process
• Liaise with Section Leader where necessary (disputed claims)
• Liaise and follow up with relevant stakeholders on outstanding claims
• Refer dispute claims to Section Leader
• Update the clients details on the system
• Update AIMS notes

2. Assist walk-in clients:
• Receive claims from walk-in clients (Funeral, Cash Backs, and Cash Providers, School funds, Life covers, 4sure and Legacy policies)
• Assist walk-in clients with any claims submission, queries/complaints
• Submit claims to clerk administrator to register the claims
• Liaise with branch offices if they will be receiving outstanding documents from the clients who submitted claims at Head Office

3. Follow up on outstanding investment claims:
• Follow- up on outstanding claims documentation/investigation (All old and new claims received)
• Update AIMS notes and e-mail branches
• Do bi-weekly follow-ups on the correspondence
• Give inputs to Section Leader on the finalization of claims without the outstanding document or to defer a claim

4. Reconcile information received, processed and finalised
• Compile monthly individual statistics
• Compile reports as requested by managers
• Compiling all branch registers month end (Death & Withdrawals), making sure all branches captures claims correctly, making follow ups on a weekly basis, confirming with all branch managers.
• Compiling all Head Office Registers (Withdrawals and Maturities).

Requirements:
• Matric
• NQF 3 in Insurance
• 1 years' experience life insurance