Claims Administrator

Claims Administrator

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives.

We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery.

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Our fast-paced and dynamic environment enables smart, self-driven people to be their best.

As global thought leaders, Discovery is passionate about innovating to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Discovery Employee Benefits

Discovery Employee Benefits is the first and only employee benefits provider to be shaping employee behaviour, creating healthier and wealthier workforces.

It is an exciting business to be in as we reimagine the way retirement savings and life insurance is brought to companies and employees.

Key Purpose

The position is responsible for the day-to-day administration and managing a small team within Group Life Operations.

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This is a core administration function, and the incumbent would be required to holistically manage and control a portfolio of different Group Life disciplines, for example monthly contribution, claim, investment option, individual transfer in, section 14, section 28 processes.

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The incumbent must ensure that processes and procedures are implemented, maintained, and improved. The incumbent needs to ensure operational activity is conducted within regulatory frameworks, accurately, effectively, and efficiently.

The incumbent must ensure that he/she has the knowledge, skills, tools, and competencies required to perform the required job within service level agreements.

The incumbent must have an appetite to be part of a growing new business unit, continuous improvement, able to adapt to change easily and play a role in change management within the team, challenge the status quo, inspire and motivate others.

The incumbent will continually review existing processes and procedures to ensure the delivery of committed services to the Group Life Clients.

Areas of responsibility may include but not limited to

  • To ensure claim assessments and payment of lump sum benefits (funeral, death, SIB and CD) payments
    Receive claims from Indexing department for assessment of the funeral and death claims – member; child or spouse claims as well as extended family members.
  • Assess each claim by verifying claim details against standard claims requirements. Liaise with Broker should documentation not be in order.
  • Should discrepancies be picked up, refer the documentation to the Forensics Department. Ensure regular follow-up until Forensics provide an investigation outcome.
  • Liaise with the Administration department to confirm cover amounts, credit control status, member covers.
    Once all documentation has been received, set up payment on the system for verification by second Assessor and Authorizer.

Receive claims for verification (second assessing) and authorizing.
Issue payment letters and/or claims decision letters to Brokers once payment has been approved.

  • Personal Attributes
  • Leading and Supervising
  • Planning & Organizing skills
  • Working with People – Communication
  • Persuading and Influencing
  • Adhering to Principles and Values – Self management
  • Delivering Results and Meeting Customer Expectations
  • Coping with Pressure and Setbacks
  • Relating and Networking
  • Teamwork and analytical skills
  • Communication
  • Problem solving
  • Initiative and enterprise
  • Learning
  • Technology
  • Education and Experience
  • Matric-essential and further studies are advantageous.
  • Telephone etiquette, detail orientated and self-driven. Customer centric focus to be evident.
  • MS Office- Advanced Excel skills, Accounting, operational processes and process mapping. Employee Benefits including Group Risk claim operations.
  • Knowledgeable on Compass; Paradigm (internal)
  • 3 – 5 years claims experience in the long-term insurance industry. Pension and Provident Fund experience is advantageous.

Employment Equity

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

EMPLOYMENT EQUITY

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

Administration Officer (Warrant Officer) – SAPS Vacancies Available

 

 

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