Econet Life (Pvt) Ltd is looking for a Claims Assessor to join the EcoSure Team. The main purpose of this role is to ensure the validity of claims in line with underwriting and claims standards and recommend claims for either payment, rejection or further investigation in line with policy.
Qualifications and Experience
A Degree in Insurance or equivalent.
• A vocational or professional qualification will be an added advantage.
• 2-4 years’ experience in a related environment.
• Analytical, conceptual and problem solving skills.
• Organization skills, specifically in the area of process management and documentation.
• Good communication skills.
• Interpersonal skills demonstrated by the ability to interact at all levels within the organization and with external parties.
Key Result Areas
• Works intimately with the Claims Officers to ensure claims are processed and feedback communicated to claimants/ witnesses and submitting service centre within 24 hours.
• Reviews verification report received from the Claims Officers for completeness to identify any anomalies and mitigate against revenue leakages.
• Reporting of claim anomalies and fraudulent activities within minutes of suspecting or identification to ensure there are no revenue leakages.
• Further investigates potentially fraudulent claims through site visits and other means to establish authenticity of a claim.
• Reprocesses claims emanating from repudiations within set timelines.
• Provides input for claims training modules to ensure all stakeholder in the claim submission or handling process are aligned to set processes and procedures.
• Prepares daily, weekly & monthly claims reports to ensure active management of the claims section to assure monthly revenue is achieved by proactively managing claim pay-outs
To apply for this job please visit econet.erecruit.co.