18 Claims Processor jobs in South Africa
Claims Processing Manager
Posted 16 days ago
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Job Description
Manage the Benefits Investigation and claims processing function, ensuring the provision of professional support services to the surviving dependents/beneficiaries (for informed allocation of benefits) to the correct beneficiaries in compliance with the Fund rules, Section 37C of the Pension Funds Act and related Acts. Ensure the timeous and accurate payment of benefits, manage issues associated with claims and benefit administration.
Duties & ResponsibilitiesManage internal departmental functions and processes
- Develop and implement plans for the section that support Pension Administration and the company's objectives, ensuring optimisation of current business and workflow processes.
- All benefit processing activities in accordance with the benefits as defined in the rules of the Fund and applicable legislation.
- Unclaimed benefits and Evidence of Survival reviews, tracing and verification.
- Fund valuation and all audits.
- Provide interpretation advice on the application of the Rules of Fund.
- Ensure that audit controls are in place and audit requests are followed up.
- Participate on the defined Committees (Benefits Committee (BC), Medical Panel (MP), Management Benefits Committee (MBC)) and take decisions based on formal documentation.
Project Management
- Participate in the Fund’s overall projects as required with continuous focus on Business Processes, system enhancements, omni channel business insight, contributing expertise to enable project objectives to be met.
- Draft reports as part of the project deliverables.
Provide input to the strategic management of the section
- Contribute ideas for improved service delivery at Management meetings.
- Compile comprehensive business reports for this function, highlighting successes and risks in terms of achieving the section’s objectives.
- Keep abreast with changes in relevant guidelines and other legislation, to make recommendations where policies and procedures need to be amended.
Oversee Section 37C dependency investigations on death benefits allocations
- Manage investigations on death benefit cases confirming dependency with recommended benefits allocation percentages for approval by Benefits Committee.
- Monitor that outstanding banking details for payment of approved death benefits are followed up, and confirmed.
- Verify that death benefits allocation reports produced are legally compliant with recommendations and reflect minimal errors.
Oversee the provision of social services to guardian cases; implementation of Benefits Committee & Medical Panel decisions and requests / referrals for case investigations and social advice from other internal departments
- Implementation of decisions, requests and referred cases, with reports and recommendations being submitted to BC, MP& BP or other internal departments.
- Ensure compliance with Fund rules and legislation to suspension, addition, termination and reinstatement of beneficiaries (widows and minor children) in compliance.
Financial Management
- Forecast annual capital and operational expenses for the section in line with corporate policy.
- Manage costs against approved budget.
- Investigate methods to contain / reduce costs.
Corporate Governance
- Ensure compliance to procedures and relevant legislation.
- Provide detailed, accurate information for internal and external audit purposes within specified deadlines.
- Action audit issues identified within time frames indicated.
- Implement controls within the section which minimize potential risk to stakeholders.
REQUIRED MINIMUM WORK EXPERIENCE AND QUALIFICATIONS
- Relevant Bachelor’s Degree, preferably in Law. Registered with professional bodies - where applicable.
- At least 6 years job-related experience, which should include at least 2 years’ experience in a management role.
- Knowledge of an African Language is an advantage.
- Working knowledge of Pension Fund Rules.
- Basic knowledge of Income Tax Act, Divorce Act, Pension Funds Act, Child Care Act, Marriage Act, Recognition of Customary Marriage Act, Mental Health Act.
- Working knowledge of Benefit administration.
- Knowledge of Law - Section 37 (C) allocation of death benefit lump sums.
- Valid driver’s license.
Should you meet the above requirements, please upload your CV to our website CVs VIA EMAIL WILL NOT BE CONSIDERED.
All suitably qualified candidates are encouraged to apply and will be considered. Our client applies the principles of employment equity as per National legislation and policy guidelines and will consider designated groups in line with these requirements.
Full spec to be shared with shortlisted candidates. Shortlisted candidates will be required to go through background screening and assessments.
Package & RemunerationR 95000 - R 12000 - Annually
- HR Services, Recruitment & Selection
Insurance Claims Consultant
Posted 18 days ago
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Job Description
Senior Short Term Insurance Claims Handler with minimum 3 years’ Personal Lines and Commercial Claims experience in senior capacity and with the required NQF4 and RE5 Certifications, required to join this Broker Firm based in Bellville, Cape Town.
Minimum requirements:
- Matric essential
- NQF4 Short Term Insurance minimum
- RE5 essential
- Minimum 3 years’ claims handling experience in Personal Lines and Commercial Insurance in a senior role required
- Flexi, Cardinal and or CIMS 360 preferred
Duties and Responsibilities:
- Oversee negotiation and settlement of claims across Personal & Commercial lines
- Claims registration
- Claims management
- Negotiate settlements
- Communication with all stakeholders
- Complaints
- Evaluate and improve claims processes
Short-Term Insurance Claims Administrator
Posted 16 days ago
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Job Description
- Make and receive calls to clients
- Gather and follow up all info and documents required to register claims
- Advise on claims under what section covered on policies
- Interact and follow up with Insurers
- Involvement with claims intermediary service (Client satisfaction)
- Follow claims through to Agreement of Loss and signed by client
- Use logic and intellect to ensure customers are treated fairly
- Build trust-based relationships with clients
Key Skills and Competencies:
- Good verbal and written communication skills at all levels
- Computer literate in Microsoft Office and internet
- Self-discipline and time management
- Punctuality
Insurance Claims Administrator East London, South Africa
Posted 16 days ago
Job Viewed
Job Description
Candidates must have the following qualifications:
- Grade 12
Competence:
- Experience (1+ Years in industry)
- Class of Business completed for STI Personal and Commercial lines
- Operational Ability
- Product Specific Training
The following additional factors will be to your (Candidates) advantage:
- Experience on SANTAM online system
- Product specific training completed with main players in insurance industry: Santam, Old Mutual, Momentum (Previously Alexander Forbes), Bryte et
Main characteristics / strong points for candidates:
- Good verbal- and written communication skills at all levels
- Computer literate in Microsoft office and internet
- Self-discipline and time management
- Punctuality
- Make and receive calls to clients
- Gathering and follow up all info and documents required to register claim.
- Advise on claims under what section covered on policies.
- Interaction and follow up with Insurers
- Involvement with claims intermediary service (Client satisfied).
- Follow claim through to Agreement of Loss and signed by client.
- Logic and intellect to ensure customers treated fairly.
- Build relationships (Trust) with clients
Commercial Insurance Claims Consultant Cape Town market related
Posted 16 days ago
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Job Description
Claims Administration
Administer complete claims process according to defined claims procedures until claims are settled.
Apply policy terms and conditions.
Make assessment of claims validity and estimate value and administer mandated claims.
Act as intermediary between insurer and client and timeously relay communication, requests and documentation.
Engage with insurers regarding recoveries, diarise follow-ups and keep clients informed.
Ensure productivity targets are met.
Contribute towards and ensure continuous improvement in own and team performance.
Adhere to company mandates.
Participate and contribute in ad hoc projects.
Report any suspected fraud, misrepresentation and/or dishonesty.
Keep accurate record of own activities.
RE 5 A MUST
MATRIC A MUST
CREDITS WOULD BE GREAT
Salary: R20 000 - R25 000
- HR Services, Recruitment & Selection
Commercial Insurance Claims Consultant Cape Town market related
Posted 16 days ago
Job Viewed
Job Description
Claims Administration
Administer complete claims process according to defined claims procedures until claims are settled.
Apply policy terms and conditions.
Make assessment of claims validity and estimate value and administer mandated claims.
Act as intermediary between insurer and client and timeously relay communication, requests and documentation.
Engage with insurers regarding recoveries, diarise follow-ups and keep clients informed.
Ensure productivity targets are met.
Contribute towards and ensure continuous improvement in own and team performance.
Adhere to company mandates.
Participate and contribute in ad hoc projects.
Report any suspected fraud, misrepresentation and/or dishonesty.
Keep accurate record of own activities.
RE 5 A MUST
MATRIC A MUST
CREDITS WOULD BE GREAT
Salary: R20 000 - R25 000
- HR Services, Recruitment & Selection
Short-Term Insurance Broker – Claims
Posted 1 day ago
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Job Description
Job Title: Short-Term Insurance Broker – Claims
Location: Durbanville, Cape Town
Salary: Market Related - Negotiable depending on experience
About the Role:
We are seeking an experienced Short-Term Insurance Broker to join our client, a well-established logistics company based in Durbanville, Cape Town. The successful candidate will be responsible for handling and managing all insurance claims (including Heavy Commercial Vehicles and Goods in Transit) within the company. This role requires someone with excellent attention to detail, strong communication skills, and the ability to liaise effectively with insurers, service providers, and internal stakeholders.
Key Responsibilities:
- Manage the full insurance claims process for HCV, GIT, and related policies.
- Liaise with insurers, assessors, and repairers to ensure efficient claims handling.
- Maintain accurate claim documentation and records.
- Provide advice and guidance to management regarding claims and risk matters.
- Ensure claims are processed timeously and in compliance with regulations.
- Build strong working relationships with insurers and stakeholders.
Minimum Requirements:
- 5+ years’ experience in short-term insurance (claims handling essential).
- Strong knowledge of HCV and GIT insurance.
- Fully qualified with RE5, FAIS Credits, and NQF 4 qualification.
- Valid driver’s licence and reliable transport.
- Excellent problem-solving and negotiation skills.
- Professional, trustworthy, and adaptable with strong attention to detail.
Skills & Attributes:
- Strong organisational and administrative skills.
- Ability to work independently and manage multiple claims simultaneously.
- Excellent verbal and written communication skills.
- Proactive, service-oriented, and deadline-driven.
Remuneration:
Basic Salary: Market Related - negotiable depending on experience
Application:
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Short-Term Insurance Motor Claims Consultant
Posted 2 days ago
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Job Description
Empowering Africa’s tomorrow, together…one story at a time.
With over 100 years of rich history and positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of an exciting growth journey, to reset our future, and shape our destiny as a proudly African group.
Job SummaryTo plan, manage, and monitor the implementation of claims management activities and processes to deliver on approved operational plans effectively and efficiently.
Job Description- Claims assessment: Assess and/or process claims following standard operating procedures.
- Customer Experience: Handle all customer interactions professionally and efficiently.
- Ad Hoc duties: Provide support to customers and team as required to ensure team performance on an ongoing basis.
- Compliance and Risk Management: Ensure all team activities adhere to relevant control, compliance requirements, and quality standards.
Further Education and Training Certificate (FETC): Business, Commerce, and Management Studies (Required)
Absa Bank Limited is an equal opportunity, affirmative action employer. In compliance with the Employment Equity Act 55 of 1998, preference will be given to suitable candidates from designated groups to promote equitable demographic representation and diversity within the bank.
Absa Bank Limited reserves the right not to make an appointment to the post as advertised.
#J-18808-LjbffrShort-Term Insurance Motor Claims Consultant
Posted 6 days ago
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Job Description
Short-Term Insurance Motor Claims Consultant
OverviewApply for this Hybrid position based in Johannesburg . This is a Full-time role with a deadline to apply by August 21, 2025 .
About the CompanyEmpowering Africa’s future, our company has over 100 years of history. We are a proud African group with regional and international expertise, committed to growth and transformation.
Job SummaryThe role involves planning, managing, and monitoring claims management activities to ensure effective and efficient delivery of operational plans.
Key Responsibilities- Claims assessment: Assess and process claims according to standard procedures.
- Customer experience: Handle customer interactions professionally and efficiently.
- Ad hoc duties: Support customers and team to maintain performance.
- Compliance and risk management: Ensure activities adhere to control, compliance, and quality standards.
Further Education and Training Certificate (FETC) in Business, Commerce, or Management Studies is required.
Equal Opportunity StatementWe are an equal opportunity employer. Preference will be given to candidates from designated groups to promote diversity. We reserve the right not to fill the position.
#J-18808-LjbffrInsurance Administrator (Claims & Policy Support) - Witbank
Posted today
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