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×Thapelo Sefalafala
Claims & Quality Assessor at IEMAS financial services co-operative
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Show profile Hide profileI am currently a claims and quality assessor at IEMAS financial services co-operative, my duties and responsibilities involve; full processing, assessing and following up of all group benefit(death)claims and credit life (disability and death) claims. checking premium data and querying discrepancies. assessing the quality/validity of the identified claim against the terms and conditions of the policy and by assuring all the supporting documentations have been submitted. assess the claims supporting documentation in terms of signed claim form, id of deceased, death certificate, bi 1663 and all other documents. claims that have outstanding documentation (relevant party will be notified of outstanding requirement). continuously updating the system and the claims registers. arranging refund and assessing the quality/validity of the identified refund. communicating claims/refund status to the relevant party timeously (includes sending repudiation letters). populating various reports and submitting to line managers. identifying and reporting on risks within responsibility which could impact negatively on stakeholders. providing technical and on job training to new team members and other staff. assisting with audits. attending telephone and emails queries and e-filling. assisting in group scheme quality assurance.
I am currently a claims and quality assessor at IEMAS financial services co-operative, my duties and responsibilities involve; full processing, assessing and following up of all group benefit(death)claims and credit life (disability and death) claims. checking premium data and querying discrepancies. assessing the quality/validity of the identified claim against the terms and conditions of the policy and by assuring all the supporting documentations have been submitted. assess the claims supporting documentation in terms of signed claim form, id of deceased, death certificate, bi 1663 and all other documents. claims that have outstanding documentation (relevant party will be notified of outstanding requirement). continuously updating the system and the claims registers. arranging refund and assessing the quality/validity of the identified refund. communicating claims/refund status to the relevant party timeously (includes sending repudiation letters). populating various reports and submitting to line managers. identifying and reporting on risks within responsibility which could impact negatively on stakeholders. providing technical and on job training to new team members and other staff. assisting with audits. attending telephone and emails queries and e-filling. assisting in group scheme quality assurance.
