Claims Assessor

**Business Unit**:Vitality Life**Function**:Claims Administration**Date**:11-Jan-2023**Discovery - VitalityLife**

**Claims Assessor**

About Discovery VitalityLife
- Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.
- About the VitalityLife Claims Team
- At VitalityLife, we are committed to providing a market-leading claims management service.
Our customers are our priority and we are dedicated to supporting them when they need us the most. We are committed to ensuring that compassion and empathy are a fundamental part of the claims experience for our customers.
- Key Purpose
- The role contributes to the organisational goals by assessing, validating and finalising of all Life Cover, Serious Illness Cover, Income Protection Cover, Disability Cover claims according to the policy terms and condition whilst still adhering to service level agreements and maintaining high service standards.
- Areas of responsibility may include but not limited to:
The successful applicant will be responsible for but not limited to the following job functions:

Assess and decide on validity of claims submitted.
Medical and financial assessing of Protection claims.
Assessing the contract validity of a claim.
Identifying possible fraud, non-disclosure, misrepresentation and pre-existing conditions.
Liaising with internal and external stakeholders to reach claim decision.
Provide input into product development and system enhancements
Complaint resolution
Coaching of administrators
- Personal Attributes and Skills:
Strong Relationships Skills.
Deciding and initiating action
Working with People
Able to work unsupervised and to take initiative
Adhering to Principles and Values
Presenting and Communicating Information
Conflict handling
Analysing
Learning and Researching
Delivering Results and Meeting Customer Expectations
Following Instructions and Procedures
Adapting and Responding to Change
Coping with extreme pressure and setbacks
Achieving Personal Work Goals
- Education and Experience:

Education
- Matric / Grade 12 is essential.
COP (Certificate of Proficiency) in life insurance would be advantageous.
Medical degree would be advantageous.
An intermediate knowledge of the Life Insurance Industry.
- Knowledge:
Microsoft Office skills, i.e. Outlook, Excel and Word are mandatory.
Previous life claims assessment would be advantageous.
An intermediate to advanced understanding of Medical conditions and diagnosis
An intermediate level of Communication Skills (verbal & written)
An intermediate level of conflict handling- EMPLOYMENT EQUITY
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.