Claims Assistant Sanlam Life Insurance Zambia Limited

Reporting to the Claims Manager – The role of the Claims Assistant is to will carry out the end-to-end management of a portfolio of insurance claims across all products and lines, deliver optimal company outcomes and swift resolution for clients and manage the plan for new claims, regularly monitoring each case for potential fraud.

Main Duties/Responsibilities

• Determine liability of claims and deny claims where applicable.
• Manage, prepare and assess claims and request claim requirements where inadequate and promptly advise clients and relevant stakeholders of decisions.
• Liaise with branches and claim notifiers/initiators when need arises.
• Daily Preparation of EFT and Mobile Claims payment files for submission to Finance for payment.
• Tracking and follow up of submitted payments for full signoff with relevant stakeholders before cutoff times on payment platforms.
• Identification & Tracking of rejected payments to resolve any outstanding payments.
• Document and provide communication on all repudiations to customer facing stuff and clients
• Resolve queries within prescribed SLA.
• Develop and implement creative solutions to respective claims, while adhering to policy definitions and regulations
• Establish and maintain relationships with a broad range of stakeholders both internal and external.
• Carries out any other assignments as delegated by supervisor.

Minimum qualifications and experience

• Grade 12 (or equivalent)
• Bachelor’s degree in Business Administration/ Human Resource or its equivalent from a recognized institution.
• Diploma in Insurance from AIIK / ACII or its equivalent from recognized institution – added advantage.
• Member of a relevant professional body– added advantage.
• Minimum of one (1) year’s relevant experience in a busy work environment.