Posted on: 06 April 2024
ID 911561

Claims Investigator and Assessor

MiWayLife is dedicated to supporting, growing and empowering clients with affordable, simple, and suitable solutions, primarily through telephonic intermediary channels. We have approximately 80 tied sales agents, all dedicated to meeting the financial needs of our clients and prospective clients.

MiWayLifes vision is to establish a world-class direct financial service business that seeks to:
  • offer its clients excellent service, superior value products, and fair treatment always;
  • be an employer of choice; and
  • be a good corporate citizen and play a meaningful role in the transformation of the Financial Services industry.
MiWayLifes culture is values-based and is built around the pillars of Accountability, Attitude, Energy Freedom and Professionalism. We are a family of vibrant and energetic free-thinkers, constantly looking to innovate and disrupt.

What will you do?

This is a specialist position that reports directly to Operations Manager: Claims. The role is accountable for undertaking investigations to verify the validity of claims. Additionally, the execution of a compliant and effective claims administration function (either Life or Funeral, or both in some cases).

Key Responsibilities Include
  • Undertake claims investigations with external parties
  • Build external partner relationships
  • Assess and execute Life claims
  • Assess and execute Funeral claims
What will make you successful in this role?

Qualification & Experience
  • Grade 12 or preferably business or commerce degree/diploma
  • Experience in financial distribution services, preferably re-assurance
  • 3 years experience as a claims assessor with specific focus in forensics investigation with external parties.
  • RE1 and Wealth Management accredited
  • Assessor certification
  • Nursing or medical background experience (optional)
  • Successful candidate must be willing to travel
It

Knowledge and skills
  • MS: Office (Excel, Word, PP, Outlook)
  • MIS
  • Thought Express
Business
  • Financial services industry knowledge
  • MiWayLife business and operating model
  • Financial services product knowledge (MiWayLife)
  • Relevant regulatory legislation and compliance knowledge (POPI etc)
  • Policy contracts governances, clauses, cover
  • Claims and assessor principles, processes and governances
  • Underwriting processes and guiding principles (basic)
  • Medical/health assessment indicators and metrics
  • Legal investigative processes (including affidavits)
  • Criminal/SAPS procedures (processing cases)
  • Call centre and sales processes
  • Client complaints processes
Personal attributes
  • Tenacity and determination
  • Good communicator/confident/assertive
  • Analytical and detail minded
  • Curious and investigating orientation
  • Sound ethics
  • Client orientated
  • Financial acumen
  • Problem solver
  • Able to build relationships/partnerships
  • Planning and organising orientation
  • Quality orientation
Qualification And Experience

Knowledge and Skills

Personal Attributes

Build a successful career with us

We are all about building strong, lasting relationships with our employees. We know that you have hopes for your future - your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realize their worth.

Core Competencies

Turnaround time

Due Date For Applications

The closing date for applications is 12 April 2024.

Please note that the recruiter reserves the right to withdraw the advertisement prior to the closing date, or to allow for further applications to be submitted after the closing date indicated.

Turnaround times

The time taken to complete this process depends on how far you progress and the availability of managers.

Our commitment to transformation

MiWayLife is committed to transformation and embracing diversity and our employment equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.
Occupation:
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