Senior Claims Assessor at Vodafone Global Enterprise

Role Purpose/Business Unit:

• As a Senior Claims Assessor, you will play a crucial role in evaluating and processing Death, Critical illness, Disability and Incapacity claims. Your primary responsibility will be to assess the validity of claims and ensure that they meet the stipulated criteria for pay-out. This role requires a keen attention to detail, excellent analytical skills, and the ability to make fair and informed decisions.

Your responsibilities will include:

• Perform all death claims related activities which include - claim processing, responding to claims related queries and complaints.
• Application of fund rules, policies, legislation, administration procedures and the service level agreement when processing
• Meet production standards in terms of quantity and quality.
• Liaise with employers and service providers.
• Attend to the fund central mailbox and respond to queries within SLA.
• Any other duties as determined by business needs and participate in all organizational events as required.
• Drafting of resolution letters.
• Good administrative skills.
• Good communication skills, verbal and written.
• Ability to work under pressure, be target driven and meet deadlines.
• Ability to investigate and report fraudulent claims
• Complaints handling
• Fulfil reporting functions, contributing to a transparent and accountable claims assessment process
• Investigate and report fraudulent claims, actively participating in complaints handling
• Meet production standards for both quantity and quality, demonstrating excellent administrative skills
• Handle death claims activities, respond to queries and complaints promptly
• Upskilling of the Junior assessors
• Assisting with Junior assessors overrides and approvals within your mandate

The Ideal Candidate for this role will have:

Must have technical / professional qualifications: 

• Matric Certificate, Computer literacy (Advanced word and Excel), RE 5- Representative, certificate related to claims assessment or long-term insurance

Core competencies, knowledge, and experience: 

• 2-4 years Group Schemes administration /claims experience expert level understanding of benefits offered in the risk benefits portfolio eg. Death, Disability, Incapacity, Critical Illness, Funeral. 
• Must have strong organisational awareness in order to anticipate the impact of actions on other groups.
• Investigation skills, problem solving, decision making.