Our claims department is looking for a Claims Administrator who has background experience in claims - specifically in funeral claims to process health and funeral claims as required.

Key Tasks
Process, and Capture, Claims Information:
-Respond to members/claimants and request all required documents.
-Validate policy status, nominated dependants and beneficiaries
-Confirm policy terms and conditions are met. (e.g. waiting periods, general exclusions)
-Check that all claim documentation is accurate, complete and compliant with protocols, processes and relevant legislation
-Clarify details regarding claims (both verbal and written)
-Capture relevant claim information (e.g., approved documents and claim related notes) on the appropriate platform (e.g., funeral claim register)
-Process claims accurately

Engage With Members/Claimants and Service Providers Regarding Queries:
-Check that all applicable documents are received and captured
-Liaise with the relevant affiliations to resolve issues around incorrect or incomplete documentation
-Obtain additional or missing information
-Provide accurate information to clients to provide excellent service
-Conduct security checks before information is disclosed to clients
-Follow-up and provide ongoing feedback to claimants and service providers until finalised
-Escalate completed claim to the Claim Assessor for final processing
-Escalate any red flags/discrepancies, if identified, to the Claims Assessor.

Perform General Administrative Tasks:
-Uphold tight SLA adherence throughout the entire claims processing activity.
-Maintain strict adherence to all verbal or written instructions
-Maintain strict compliance with company policies and regulatory requirements
-Keep abreast of amendments to policy rules, benefit options, legislation, protocols, processes and systems
-Undertake any other duties as determined by the business needs