RESPONSIBILITIES:

Process Claims

Review applications/claims received for various types of exits or claims
Check that all supporting documentation is attached as per the requirements of the specific claim
Evaluate the member records reflected in the documentation and update accordingly to ensure accurate information is reflected
Request memberâs information for inclusion in the benefits application form, where missing information is identified

Process payment of claims:

Review the initial payment, based on a review of the particulars of the case
Reconcile purchase of service figures, checking that all outstanding service has been calculated correctly for payments
Upload supporting documentation for benefit payments, ensuring accuracy
Checking whether beneficiaries indicated qualify as dependents according to set criteria, for instructions for payments
Review the calculation against the information available on the member records, confirming whether correct or supplying reasons for rejection
Review the summary of rejected applications/claims; identifying reasons for rejection based on rules of the various Funds/schemes
Route the rejected applications/claims â in terms of the standard procedure
Ensure that all exceptions (where applicable) related to death distributions, service period recognition verification, fraud and risk issues, contribution adjustments, benefit distribution verification, payment reversals, unclaimed benefits, standard legal issues and the updating of banking details have been resolved in accordance with the relevant policies and procedures
Check that all documentation required for payment is attached and that the correct benefit is being paid to the member, based on established criteria
Review the benefit application form and validate the content

Initiate the payment instruction
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