Claims Consultant - Johannesburg, South Africa - Reinsurance Group of America

    Reinsurance Group of America
    Reinsurance Group of America Johannesburg, South Africa

    2 weeks ago

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    Description

    Position Overview

    The Claims Consultant assesses and manages claims effectively and efficiently, within the required SLA, ensuring optimal profitability of the business.

    Responsibilities

  • Claims assessment and management of Individual Life claims across all benefit types, for the South African operation, as well as other benefits relevant to the business (e.g., credit life, funeral).
  • Provide quality technical support and training to clients.
  • Proactive case management of disability income claims.
  • Assist with client audits where required.
  • Identify trends and report to Head of Claims.
  • Assist with developing and delivering claims value-added solutions to clients.
  • Identify fraud, waste and abuse and act in accordance with internal orocesses.
  • Requirements

    Required:

  • At least 3 years assessment experience of all major benefit types in the Individual Life sector.
  • At least 2 years assessment experience of credit life and funeral claims.
  • Degree in Occupational Therapy or Physiotherapy or any other relevant qualification.
  • At least 3 years clinical experience in their field.
  • Medical and functional knowledge that can be applied in an insurance setting.
  • Computer literate and proficient in Microsoft Office.
  • Flexibility to handle diverse tasks in a fast-paced environment.
  • Innovative problem-solving ability.
  • Client-centric approach with strong networking skills.
  • Preferred:

  • Understanding of current industry trends and legislation, impacting life insurance and claims.
  • Understanding of the non-disclosure process and the application at claims stage.
  • Knowledge of the Ombudsman process and dealing with complaints.
  • Ability to view the bigger picture and impact on the business.
  • Ability to transfer knowledge to others.
  • Good presentation skills.