Claims Assessor - Specialist
About Discovery Discoverys 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:
- Assess and decide on validity of claims submitted.
- Medical and financial assessing of Protection claims.
- Assessing the contract validity of a claim.
- Identifying possible fraud, non-disclosure, 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
- Coaching of administrators
- 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
- Matric/Grade 12 is essential
- 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.
- Microsoft Office skills, i.e. Outlook, Excel and Word are mandatory.
- Extensive knowledge of the Life Insurance Industry.
- Experience within the UK Life Claims environment would be advantageous.
- An advanced level of understanding of Medical conditions and diagnoses
- An advanced level of Communication Skills (verbal & written)
- An intermediate level of conflict handling
The Companys 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.
