
Senior & Junior Disability Claims Assessor on Pension and Provident Funds
Claims assessor required with sound knowledge specifically on permanent and temporary Disability, and Critical Illness.
Pretoria, Gauteng
Permanent position
Remuneration is market related/negotiable depending on experience.
EE/AA, Non-EE/AA
Areas of Responsibility
- Perform an overview process on the complete claim processing cycle.
- Quality assure and review the claim documentation to ensure the documentation is accurate, complete, and compliant with relevant legislation.
- Report on inflow and outflow of claims statistics to the underwriters and the Fund.
- Process claims payment once approved within the agreed service levels.
- Keep abreast of all requirements in the retirement industry as set out by the FSCA and the relevant legislation.
- Process claims according to the rules, policies, legislation, administration procedures and the service level agreement.
- Provide accurate information to clients to ensure that they receive appropriate service.
- Build and maintain relationships with internal and external stakeholders.
- Make recommendations to improve client service and fair treatment of clients within their area of responsibility.
- Meet the required standards in terms of quantity and quality.
Record Keeping and Filing
- Ensure all claims documentation is uploaded on the client profile on the Company’s system.
- Record all updated member notes on the Company system.
- Claims Query resolution from underwriter and fund.
- Attend to all email and telephonic enquiries both internal and external.
- Follow through and provide fund, underwriter, and client with on-going feedback until enquiry is resolved.
- Support a positive and responsive climate for client enquiry resolution.
- Team Support
- Accept accountability and take responsibility for any work done or allocated.
- Display a willing and helpful attitude.
- Build and maintain relationships at all levels with clients, service providers and internal departments to enhance organizational effectiveness and efficiency.
- Use your best endeavors to properly conduct, improve, extend, develop, promote, protect, and preserve the business interests, reputation, and goodwill of the company.
Time Management
Excellent time management with the ability to work independently.
Flexible and ability to work under pressure and multitask.
Qualifications and Experience
Junior Position
- Matric
- Any industry NQF level 5 certificate
- RE5 Regulatory Exam (Advantage)
- At least 3 years working experience specifically on permanent/temporary disability and critical illness.
- Problem solving skills.
- Attention to detail.
- Good communication skills (written and verbal) both Afrikaans and English.
Senior Position
- Matric
- Any industry NQF level 5 certificate
- FSCA registration as representative in CAT I (Advantage)
- RE5 Regulatory Exam (Advantage)
- Pension Fund Benefits Class of Business Certificate (Advantage)
- Long Term Insurance Class of Business Certificate (Advantage)
- At least 5 years working experience specifically on permanent/temporary disability and critical illness.
- Problem solving skills.
- Attention to detail.
- Good communication skills (written and verbal) both Afrikaans and English
Desired Skills
- Any type of medical qualification and/or background
- Nurse
- Occupational therapy or physiotherapist
Please submit your application before 30 November 2023 to ileneg@phakama.co.za






