Senior Claims Assessor
1 week ago
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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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