Job Description
The Technical Claims Administrator is a key member of the PPS Life Operations and Digital team. The role is responsible for delivering accurate, efficient, and high-quality technical claims processing across all servicing and administrative functions.
This includes managing end-to-end claims administration, ensuring compliance with procedures, resolving queries, validating documentation, and maintaining strong stakeholder engagement. The role requires sound decision-making within mandate, a strong attention to detail, and the ability to consistently meet productivity and service-level targets.
Job Industry
Job Salary Currency
SARJob Salary Fixed
NoKey Deliverables
Technical Claims Processing & Quality Assurance
- Perform end-to-end technical administration of life insurance claims, ensuring documentation accuracy and compliance with work instructions and checklists.
- Validate member, policyholder, medical practitioner, and banking information with a high degree of accuracy.
- Ensure all supporting documents, assessments, and correspondence are uploaded to the appropriate systems promptly and accurately.
- Maintain accurate records and ensure compliance with regulatory and company standards.
Claims Communication & Stakeholder Engagement
- Draft and send professional correspondence, including claims letters, emails, and communication to members, intermediaries, and internal teams.
- Respond to stakeholder queries timeously and professionally, ensuring clarity and completeness.
- Verify and update member contact and personal information to maintain data accuracy.
Workflow & Service Delivery
- Support the daily management of work volumes, ensuring adherence to service level agreements (SLAs), turnaround times, and daily productivity targets.
- Prioritise workload effectively and escalate when necessary to ensure seamless claims processing.
- Work collaboratively within the team to meet operational and quality-related metrics.
Operational Support & Continuous Improvement
- Assist the team and management with general operational duties, including reconciliation tasks, reporting support, and workload balancing.
- Identify process gaps, inefficiencies, or trends and recommend improvements to simplify and enhance operational efficiency.
- Maintain up-to-date product knowledge to support accurate claims decisions and resolutio
Professional Qualifications
| Industry | Qualification |
|---|---|
| Administrative and Support Services | A tertiary qualification (NQF6 or above) with relevant business orientation advantages Experience: 2+ years of experience in an administration environment. Experience in the policy administration environment would be beneficial. Call Centre experience would be beneficial to assist with telephonic enquiries |
Essential Qualities
| Essential Qualities |
|---|
Competencies:
|