Senior Claims Assessor

1 week ago


Cape Town, South Africa Old Mutual Full time
Job title : Senior Claims AssessorJob Location : Western Cape, Cape TownDeadline : December 22, 2024Quick Recommended Links
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Job Description

Role Overview

  • Use your specialist technical medical knowledge to assess risk for business and/or specific products.
  • Uses specialist technical knowledge to evaluate and manage the validity of contracts and determine and manage the liability of claims (Assessor).
  • Determines, selects and accepts risk and/or liability on behalf of the organisation.
  • Evaluates proposals and medical / financial evidence against business rules and practices.
  • Manage a portfolio of clients which encompasses presentations, reporting and assistance with the claims process.
  • Ongoing process optimisation & improvements within teams with a focus on implementing best practice in the longer term
  • Acts as mentor and coach for new staff
  • Collaborates effectively with others to achieve team goals
  • Regular engagement with Corporate teams, providing feedback to product team on claims trends
  • Accepts and lives the company values

Role Requirements

  • Grade 12/Matric with Biology, Mathematics
  • Completed medical / medically aligned Degree, e.g. Nursing, Occupational Therapy, Physiotherapy
  • Minimum 2 years Clinical experience
  • Experience in the Financial Service Industry is highly advantageous
  • Specialised medical knowledge through learning or experience - essential
  • Disability Claims assessment experience in a Group Assurance or Risk environment and GAP product knowledge - advantageous 
  • Well developed interpersonal skills
  • Strong verbal and written communication skills
  • Attention to detail
  • Good presentation skills
  • Computer literate and proficient in MS Office programmes e.g. Word & Excel
  • Have sound analytical and problem solving abilities with a focus on attention to detail
  • Work effectively with internal and external colleagues and clients to accomplish organisational and team goals
  • Enjoy working in a progressive environment

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