Claims Assessor - Sandton

Discovery – VitalityLife · Claims Assessor (Senior) · 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 who ...

Job description

Discovery – VitalityLife

Claims Assessor (Senior)

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 main purpose is to assess Income Protection (IP) claims in line with current UK industry best practice and within the required service levels.

Areas of responsibility may include but not limited to:

The successful applicant will be responsible for but not limited to the following job functions:

• Medical and financial assessment of Income Protection claims.
• Assessing the contractual validity of a claim.
• Identifying possible fraud, misrepresentation and pre-existing conditions.
• Liaising with internal and external stakeholders to reach claim decision.
• Provide input into product development and system enhancements
• Complaint resolution
• Support team through knowledge sharing (medical, technique)
• Coaching of administrators

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

Education and Experience:

Education

• Matric/Grade 12 is essential
• A minimum of 3 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.
• Intermediate knowledge of the Life Insurance Industry.
• Experience within the UK Life Claims environment would be advantageous.
• An intermediate to advanced understanding of Medical conditions and diagnoses
• An intermediate to advanced level of Communication Skills (verbal & written)

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.