Youll be based at our head office in Sandton, Johannesburg. Youll report to the Team Leader: Claims
Assessing responsible for Claims.
Relevant tertiary qualification; a medical degree preferable
Your Outputs (include but is not limited to):
- Evaluate claims forms and supporting documentation in preparation of making an payment decision
- Gathering information and various types of reports from medical practitioners
- Compare the reorts to our exisitng claims criteria to establish if claim is payable
- Decide on levels of provisions to be raised based on information received
- Writing claims assessment standards/policies
- Auditing/QA of work done by peers
- Determine requirments / documents required to evaluate claims
- Liase with relevant re-insurers to determine validity of claims and get their approvals where required
- Explain and communicate final decisions to brokers and clients