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Technical Claims Assessor

Nedbank Private WealthDurban, KwaZulu-Natal, South Africa

30+ days ago

Job description

Overview

Job Requisition :
TA Specialist : Refilwe Falatsi
Closing Date : 5 August 2025
Location : Durban
Cluster : Personal and Private Banking Nedbank Insurance Operations - Long Term Insurance Claims
Please Note : Preference will be given to applicants from Underrepresented Groups

Job Purpose

To accurately assess investigate and process long-term insurance claims including death disability and critical illness claims and ensure prompt and fair payment of benefits in accordance with the policy terms and conditions.

Responsibilities

Stakeholder Engagement

Develop effective relationships with stakeholders (internal - client solutions team / client experience and external clients hospitals doctors labs and reassurers).

Drive and support effective teamwork within the department.

Effective client communication throughout the claims journey.

Ensure information is provided correctly to stakeholders by maintaining and sharing knowledge.

Process Management

Meet client needs by ensuring claims are processed according to service level agreement and insurance policy terms and conditions

Professional Development

Engage in appropriate training interventions to promote own professional development.

Adhere to organizational best practice and legislative requirements.

Keep abreast of legislation and other medical industry changes that impact on the role by reading the relevant newsletters websites and attending sessions.

Improve personal capability and stay abreast of developments in the field of expertise by identifying training courses and career progression for self through input and feedback from managers.

Ensure personal growth and enable effectiveness in performance of roles and responsibilities by ensuring all learning activities are completed experience practiced and certifications obtained and / or maintained within specified time frames.

People Specification

Essential Qualifications - NQF Level

Matric / Grade 12 / National Senior Certificate

Professional Qualifications / Honours Degree

Preferred Qualification

Physiotherapy / Occupational Therapy / Nursing / Junior Doctor / Medical related degree

Preferred Certifications

Beneficial : Higher Certificate in Long Term Insurance

Minimum Experience Level

3 - 6 years as a Technical Claims Assessor

2 - 3 years Long Term Insurance

Must have medical underwriting experience. (non-negotiable)

Technical / Professional Knowledge

Administrative procedures and systems

Insurance Policy Technical Knowledge

Business principles

Governance Risk and Controls

Relevant regulatory knowledge

Relevant software and systems knowledge

Business writing skills

Medical and Financial Knowledge

General Communication Skills

Behavioural Competencies

Customer Orientation

Collaborating

Monitoring Information

Decision Making

Initiating Action

Work Standards

Planning and Organizing

Communication

Please contact the Nedbank Recruiting Team at

Key Skills

Intelligence, Information Technology Sales, Accounts, Auto Parts, Data Analysis

Employment Type : Full Time

Experience : years

Vacancy : 1

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Technical • Durban, KwaZulu-Natal, South Africa

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