Job Description

Job Classification

Job Requisition: 140914 TA Specialist: Refilwe Falatsi Closing Date: 18 July 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/Honour's 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 +27 860 555 566