Primary Purpose of the Role :
To ensure claims are assessed accurately and communicated effectively, in line with business rules and service level agreements.
Key Responsibilities :
- Assess an average of 7 benefits per day.
- Communicate formally and professionally.
- Independently assess claims within authority limits.
- Maintain service level discipline.
- Achieve Quality Assurance score above 85%.
- Present complex claims to internal committees for verification.
Requirements : Work Experience :
3–5 years in Life Claims Assessment (Death, Disability, Severe Illness).2–3 years in Underwriting.Education :
Required : Matric + Diploma / bachelor’s in health-related field (Nursing, OT, Physio) or equivalent experience.Preferred : Risk management and medical terminology knowledge.