Claims Administrator - Funeral

• Respond to members/claimants and request all required documents.
• Validate policy status, nominated dependants and beneficiaries
• Confirm policy terms and conditions are met. (e.g. waiting periods, general exclusions)
• Check that all claim documentation is accurate, complete and compliant with protocols, processes and relevant legislation
• Clarify details regarding claims (both verbal and written)
• Capture relevant claim information (e.g., approved documents and claim related notes) on the appropriate platform (e.g., funeral claim register)
• Process claims accurately

• Check that all applicable documents are received and captured
• Liaise with the relevant affiliations to resolve issues around incorrect or incomplete documentation
• Obtain additional or missing information
• Provide accurate information to clients to provide excellent service
• Conduct security checks before information is disclosed to clients
• Follow-up and provide ongoing feedback to claimants and service providers until finalised
• Escalate completed claim to the Claim Assessor for final processing
• Escalate any red flags/discrepancies, if identified, to the Claims Assessor.

• Uphold tight SLA adherence throughout the entire claims processing activity.
• Maintain strict adherence to all verbal or written instructions
• Maintain strict compliance with company policies and regulatory requirements
• Keep abreast of amendments to policy rules, benefit options, legislation, protocols, processes and systems
• Undertake any other duties as determined by the business needs

• Matric

• Minimum 2 years in the insurance industry
• Experience in customer care and service delivery

• Computer Literate
• Strong inter-personal skills
• High standard of verbal and written communication skills

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