Technical Claims Assessor
Technical Claims Assessor
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1 Vacancy
Job Description
Job Classification
- Job Requisition: 140914
- TA Specialist: Refilwe Falatsi
- Closing Date: 5 August 2025
- Location: Durban
- Cluster: Personal and Private Banking Nedbank Insurance Operations - Long Term Insurance Claims
- Please Note: Preference will be given to applicants from Underrepresented Groups
Job Purpose
To accurately assess investigate and process long-term insurance claims including death disability and critical illness claims and ensure prompt and fair payment of benefits in accordance with the policy terms and conditions.
Job Responsibilities
Stakeholder Engagement:
- Develop effective relationships with stakeholders (internal - client solutions team/client experience and external clients hospitals doctors labs and reassurers).
- Drive and support effective teamwork within the department.
- Effective client communication throughout the claims journey.
- Ensure information is provided correctly to stakeholders by maintaining and sharing knowledge.
Process Management:
- Meet client needs by ensuring claims are processed according to service level agreement and insurance policy terms and conditions
Professional Development:
- Engage in appropriate training interventions to promote own professional development.
- Adhere to organizational best practice and legislative requirements.
- Keep abreast of legislation and other medical industry changes that impact on the role by reading the relevant newsletters websites and attending sessions.
- Improve personal capability and stay abreast of developments in the field of expertise by identifying training courses and career progression for self through input and feedback from managers.
- Ensure personal growth and enable effectiveness in performance of roles and responsibilities by ensuring all learning activities are completed experience practiced and certifications obtained and/or maintained within specified time frames.
People Specification
Essential Qualifications - NQF Level
- Matric / Grade 12 / National Senior Certificate
- Professional Qualifications/Honours Degree
Preferred Qualification
Physiotherapy/ Occupational Therapy/ Nursing/ Junior Doctor/ Medical related degree
Preferred Certifications
Beneficial: Higher Certificate in Long Term Insurance
Minimum Experience Level
- 3 - 6 years as a Technical Claims Assessor
- 2 - 3 years Long Term Insurance
- Must have medical underwriting experience. (non-negotiable)
Technical / Professional Knowledge
- Administrative procedures and systems
- Insurance Policy Technical Knowledge
- Business principles
- Governance Risk and Controls
- Relevant regulatory knowledge
- Relevant software and systems knowledge
- Business writing skills
- Medical and Financial Knowledge
- General Communication Skills
Behavioural Competencies
- Customer Orientation
- Collaborating
- Monitoring Information
- Decision Making
- Initiating Action
- Work Standards
- Planning and Organizing
- Communication
Please contact the Nedbank Recruiting Team at
Employment Type
Full Time
