Specialist: Underwriting and Claims

7 months ago

Johannesburg, South Africa PPS Recruitment Full time

**Job Advert Summary**:
This role reports to the Executive Underwriter. The Senior Life Underwriter is responsible for underwriting life, disability, critical illness, sickness and permanent incapacity cover within agreed underwriting authority limits.

The incumbent will deal with technical and complex underwriting queries and/or complaints providing an excellent service offering. A close relationship with Research & Development to support interdepartmental and wider organizational goals.

Incorporated in the role will be a meaningful contribution to the claims team in the assessment and management of long-term Sickness, Permanent Incapacity and Disability claims. The role will transfer specialist claims knowledge, in-depth process knowledge and client centric principles. This will include imparting experience in forensic and external relationships with key industry players in the preventon and investigation of fraud and related criminal activity.

**Minimum Requirements**:
**Education**:

- Financially / Medically aligned degree, e.g. Nursing, BCOM, BSC or a three (3) year related diploma

**Experience**:

- 10+ years underwriting experience in long term insurance
- 10+ years insurance industry experience

**Knowledge and Skills**:

- Sound medical & life assurance knowledge
- Fluent in English both written and verbal
- Good computer knowledge - MS Outlook, Excel and Word are necessary
- Must have a mature, disciplined and driven personality
- Ability to work independently as well as being a good team-player with excellent interpersonal skills
- Deadline/target driven, with ability to work under pressure
- Logical and analytical
- Technical knowledge and experience with technology relative to industry.
- Demonstrates the ability to understand and interpret key technology platforms relative to PPS
- Excellent understanding of current and emerging technological trends

**Competencies**:

- Must use underwriting initiative and discretion in decision making
- Communication skills. Have a skill set that includes good levels of communication (both written & verbal up to senior & executive level), negotiation, analytical and numerical skills
- Planning and organizing
- Attention to detail
- Client centricity
- Resilience
- Complex problem solving

Adapting and responding to change

**Duties and Responsibilities**:
**Process optimization and efficiencies**
- To underwrite cases within the agreed service level agreements.
- Responsible for achieving and maintaining standards in underwriting Life
- Provide constructive feedback to underwriting manager/underwriter regarding matters arising
- Assess and authorise cases specific underwriting cases.
- Responsible for financial underwriting to ensure accurate financial underwriting decisions.
- Participation in projects to improve departmental service-owning your role in the project and completing tasks as required by providing input.
- Contributing to the clams department. Specifically within the role of fraud and related crtiminal activity prevention.

**Risk and Compliance**
- Adhere to internal SLA's to ensure operational efficiency and achievement of agreed customer service standards
- Proficient in the assessment and management of underwriting decisions
- Must understand the underwriting environment and general protocols and processes
- Ensure adherence to regulatory and compliance requirements
- Proactive and effective responsiveness to issues regarding fraud, related criminal activity and the prevention thereof.

**People and Culture**
- Checking and Authorization of underwriting decisions in terms of published delegation of authority.
- Collaboration with relevant stakeholders: Research & Development, Member Services and Intermediary Services
- Deal with Arbitration and Ombudsman cases and collaborate with other stakeholder during the Complaints process
- Contribute and assist to review processes and protocols where required to assist in PPS’ delivery of quality underwriting decisions
- Forge strong working relationships with stakeholders

**Knowledge Champion**
- Provide guidance and support to junior underwriters
- Empower team members with transfer of knowledge, be the Underwriting Team SME
- Ensure that own knowledge is kept abreast with industry & regulatory information and changes through various internal and external information sources
- Provide technical information and support
- Referring cases to Reassurers
- Underwriting Life, TPD, Critical Illness and IP cover
- Discussing Counter offer letters with Financial Advisors
- Provide information and support regarding fraud and related criminal matters.

**Coaching & Feedback**
- Support Managers and Learning and Development to identify learning objectives; implement training interventions and create development plans.
- Support active learning plan for onboarding of new employees and constant learning for all employees through coaching and other interventions.

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