Claims Consultant

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