to the ongoing enhancement and execution of the claims assessment methodology across Critical Illness Disability benefit lines. Approves or declines claim submissions without supervision within company guidelines to claims assessors and consultants. Guide team members with risk assessment techniques, medical knowledge the claims assessment methodology, including: Current best industry and company practices Claims research to ensure consistent application of these in the claims assessment environment. To partner and collaborate
Manage the Benefits Investigation and claims processing function, ensuring the provision of professional payment of benefits, manage issues associated with claims and benefit administration BASIC JOB DESCRIPTION the defined Committees (Benefits Committee (BC), Medical Panel (MP), Management Benefits Committee (MBC)) cases; implementation of Benefits Committee & Medical Panel decisions and requests / referrals for case background screening and assessments. The post MANAGER: CLAIMS PROCESSING appeared first on freerecruit.co.za
philosophy, analyse claims and other data when assessing claims. Providing feedback on all claims, liaising with decisions on claims worked on. Assessment of income, disability and critical illness claims following policy policy terms and claims philosophy as well as facilitate case management programmes where applicable You'll report to the Team Leader: Claims Assessing responsible for Claims. Your qualifications: • Grade 12 qualification; a medical degree preferable Your Outputs (include but is not limited to): • Evaluate claims forms
IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation from medical practitioners Compare the reorts to our exisitng claims criteria to establish if claim is Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals qualification; a medical degree preferable Min 2-3 years experience in Life Insurance Assessing Medical Background
IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation from medical practitioners Compare the reorts to our exisitng claims criteria to establish if claim is Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals qualification; a medical degree preferable Min 2-3 years experience in Life Insurance Assessing Medical Background
philosophy, analyse claims and other data when assessing claims. Providing feedback on all claims, liaising with decisions on claims worked on. Assessment of income, disability and critical illness claims following policy policy terms and claims philosophy as well as facilitate case management programmes where applicable You'll report to the Team Leader: Claims Assessing responsible for Claims. Your qualifications: • Grade 12 qualification; a medical degree preferable Your Outputs (include but is not limited to): • Evaluate claims forms
agents determine premium costs Evaluate insurance claims for accuracy and the coverage amount Corporate
agents determine premium costs Evaluate insurance claims for accuracy and the coverage amount Corporate
end general ledger reconciliation reports, for medical aid, provident fund, union
Please apply online. FROGG Recruitment We offer Medical Aid Contribution, Provident Fund Contribution