Claims and Underwriting Administrator - Sandton, South Africa - Discovery Ltd.

Discovery Ltd.

Verified Company

Sandton, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Business Unit:
Discovery Employee Benefits
Function:Administration and Office Support
Date:5 Jul 2023Achieve more than
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YOU BELIEVE

Discovery Employee Benefits

Client Care Team:
Claims and Underwriting Administrator
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About Discovery

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 fastpaced and dynamic environment enables smart, selfdriven 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.

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Key Purpose of the role

Assisting the underwriters with general administration related to underwriting. Ensure brokers are well informed by providing accurate information to them in order to adequately support clients. Compile underwriting status reports. Provide or receive half cost medicals from other insurers. Ensure claim assessments and payment of lump sum benefits (Funeral, death, SIB and ICB) payments.

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Principle Accountabilities

Enhance group risk revenue and profit streams to meet business objectives through the following:
Claims:
Compile claims reports for brokers from SFE and Compass
Manage claim related queries and provide the client with feedback thereof
Receive claims from indexing department for assessment of the funeral and death claims member; child or spouse claims as well as extended family members. Assess each claim by verifying claim details against standard claims requirements. Liaise with Broker should documentation not be in order
Should discrepancies be picked up, refer the documentation to the Forensics Department. Ensure regular followup until Forensics provide an investigation outcome
Once all documentation has been received, set up payment on the system for verification by second Assessor and Authoriser
Receive claims for verification (second assessing) and authorizing
Issue payment letters and/or claims decision letters to Brokers once payment has been approved
Underwriting:
To send medicals requirements requests to brokers/SC in order to be completed by member for underwriting members' over the acceptable limit
Link the received completed medicals to the system and allocate to the underwriters for a decision
Ensure all documents submitted are correct and completed in full. Where documents are missing, source the documents from Meditech or other Pathologists
Once all documentation is attached on SFE, complete audit for Member and move it to the Underwriters
Compile underwriting admin reports for brokers from SFE and Compass
Investigate reasons for anomalies on any underwriting admin process and troubleshoot. Look out for members that need decisions to be reapplied
Deal with escalated calls or queries to ensure high quality

Education and Experience

Matric
Essential

Relevant Industry Qualifications

Advantageous
MS Office experience especially Excel and Compass
Essential
Group Life/Risk Insurance experience
Essential
3 to 5 years working experience within a Group Life Administration environment

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
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.