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Job Summary
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.
Isilumko Staffing
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