Claims Assessor

8 hours ago

Sandton, South Africa Discovery Full time R1 000 000 - R2 000 000 per year

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:

  • The role of a Specialist Claims Assessor is to assess all claims. This will predominately include the highest value claims coming in, complex claims and escalations.
  • They will be required to manage a larger and more intricate portfolio to ensure that necessary turnaround times are met.
  • Skilled liaison between the advisers, customers, and internal and external stakeholders
  • Assistance with complaint resolution, including escalated complaint calls and FOS cases.
  • Facilitating and chairing the bi weekly complex claims meetings within the team
  • Coaching and upskilling junior members of the team.
  • Review and approval of claim decisions that fall outside of other assessor's financial authority limits when necessary. This includes the review of any written communication relating to the claim decision.
  • Provide input into product development and system enhancements.
  • Providing managerial support in managers absence
Personal Attributes and 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 and resolution
  • Collaboration and team work
  • Learning and Researching
  • Delivering Results and Meeting Customer Expectations
  • Following Instructions and Procedures
  • Adapting and Responding to Change
  • Coping with pressure and setbacks
  • Achieving Personal Work Goals
 
Technical Skills
·       Effective Communication Skills (verbal & written)
·       Analytical
·       Conflict handling
·       Soft skills
Education and Experience:
Education
  • Matric/Grade 12 is essential
  • Biology
  • A minimum of 5 years prior experience within a claims environment in the life insurance industry is essential.
  • COP (Certificate of Proficiency) in life insurance would be advantageous.
  • Medical degree or diploma would be advantageous.
Knowledge:
  • Microsoft Office skills, i.e. Outlook, Excel and Word are mandatory.
  • Extensive knowledge of our product in the Life Insurance Industry.
  • Experience within the UK Life Insurance Industry would be advantageous.
  • An advanced level of understanding of medical conditions and diagnoses
  • Basic Financial / Accounting knowledge would be advantageous.
  • Experience in Vitality Life Claims system would be advantageous.

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.

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