The incumbent will be responsible and accountable for the administration of disability and critical illness claims.
WHAT WILL YOU DO?
- Recording all claims notified to RMA Life on the current recording platform
- Understanding Group Risk Policies to ensure that records are correct and available to the Group Risk team for analysis and business planning.
- Document management as required on all incoming documents
- Preparing the claim payment calculation for approval
- Preparing the payment requisitions for claims and underwriting
- Preparing the payment requisitions for ad hoc claim payments: doctor’s OT’s, nurses
- Preparing the payment correspondence
- Ensure that service level agreements are adhered to and that claims are assessed and reviewed to the clients’ satisfaction.
- Ensure that records are maintained and updated as necessary– spreadsheets, systems, folders
- Liaise with the relevant role players for claims administration requirements
- Reports as required
- Maintain the competence within the Company to ensure that claims queries are dealt with efficiently, service level agreements with internal and external clients are met and quality control is adhered to according to the audit requirements.
- Deliver effective and consistent service and support to external clients within specified service level agreements.
- Engage with clients in a client centric manner (Client Services, keep clients informed (verbally and/or in writing) if any unresolved queries are outstanding
- Ensure that good knowledge of processes, practices, policies, terms and conditions and their application is maintained.
- Ensure standards are met relative to policy wording, market practice and the Company practice (service level agreements)
- Assist with processes not within portfolio when required
- Provide administrative support for a variety of Claims practices (Internal Process)
- Contribute to the overall team achievement of set team targets through excellence.
- Answer and provide first time resolution and quality driven responses to all correspondences.
- Adhere to the standard operating procedures when communicating with clients through recording and updating of calls, update query with actions taken and escalate to the relevant assessor on the claims system.
- Adhere to the Treating Customers Fairly principles.
- Make recommendations to improve client service and fair treatment of clients within area of responsibility.
- Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
- Self-management and teamwork (People)
- Develop and maintain productive and collaborative working relationships with colleagues, peers and stakeholders.
- Continuously develop own expertise.
- Contribute to continuous innovation through the development, sharing and implementation of new ideas.
- Take ownership for driving your career development.
- Contribute to financial controls and planning (Finance)
- Identify solutions to enhance cost effectiveness and increase operational efficiency.
- Responsibly managing financial and other company resources under your control.
WHAT YOU'LL BRING TO THE TABLE?
- Matric
- 3-5 years administration experience in Group Risk in a claim’s environment
- Experience in managing a portfolio of clients, providing feedback on claim trends
WHAT WILL YOU GET IN RETURN?
We offer great opportunities for personal and professional development in a stable company that’s 130 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.
Turnaround time
The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. Kindly note that should you not receive a response within 21 days please consider your application unsuccessful.
Our Commitment to transformation:
In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets; preference may be given, but is not limited, to candidates from under-represented designated groups.
- Matric
- 3-5 years administration experience in Group Risk in a claim’s environment
- Experience in managing a portfolio of clients, providing feedback on claim trends