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Disability Claims Assessor

Business:  Discovery Employee Benefits
Function:  Administration and Office Support
Date:  07-Apr-2021

 

Achieve more than     YOU BELIEVE  

 

 

 

 

 

 

 

 

 

 

 

 

Discovery Employee Benefits

 

 Disability Claims Assessor

 

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 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 Discovery Employee Benefits

 

Discovery Employee Benefits is the first and only employee benefits provider to be shaping employee behaviour, creating healthier and wealthier workforces. It is an exciting business to be in as we reimagine the way retirement savings and life insurance is brought to companies and employees.

 

Key Purpose

 

The primary function of this role is to effectively medically and technically assess and manage disability claims submitted to Discovery Group Risk Disability Claims as well as take opportunities for involvement in projects run by the team and business to develop the team, business and yourself. The incumbent needs to ensure operational activity is conducted within regulatory frameworks, accurately, effectively and efficiently. The incumbent must ensure that he/she has the knowledge, skills, tools and competencies required to perform the required job within service level agreements. The incumbent must have an appetite to be part of a growing new business unit, continuous improvement, able to adapt to change easily, challenge the status quo, inspire, and motivate others.

 

Areas of responsibility may include but not limited to

 

  • Ensure the effective validation and assessment of all disability claims according to company policy whilst having a client centred approach ingrained into the communication and management of all relevant stakeholders and clients
  • Review and follow up on all types of disability claims within agreed authority structures and targets in accordance to client service levels, claims management and process requirements
  • Makes correct decisions - medically researched, legally defendable, fair, equitable and justifiable final decisions
  • Communicate to internal and external stakeholders on set requirements, decision letters and progress on claims in a clear, friendly, and concise manner using appropriate language and a client centric approach
  • Ensure all Internal and External communication (Written and Verbal) is done so in a professional manner and in line with the company policy and does not contravene the POPI Act.
  • Ensure that all queries are answered correctly in a logical and fair manner in accordance client service levels using a client centric approach
  • Bring medical expertise, experience and skills and assist with continual medical training, coaching, mentoring, development, empowerment, and performance of fellow disability claims team members.
  • To liaise with associated persons such as Medical Officers, Reinsurers, Legal Officers, rehabilitation consultants, investigators, and management
  • Work effectively in a team environment, share information, and provide support to other team members
  • Contribute to team and cross-team processes, discussions, interactions, activities, and programmes
  • Create and Implement initiatives and opportunities for change and improvement – within the team, business, and self.
  • Maintains and develops professional relationships with internal and external clients and ensure the best communication with customers using a client centric approach.
  • Seeks and receives the advice and input of others
  • Seeks involvement in projects of varying subject matter
  • Participate in personal and professional development activities, training, and courses

Additional ad hoc preparations for Audits (Internal and External), Compliance audits and TCF

Personal Attributes

  • Leading and Supervising
  • Planning & Organizing skills
  • Working with People - Communication
  • Persuading and Influencing
  • Adhering to Principles and Values – Self management
  • Delivering Results and Meeting Customer Expectations
  • Coping with Pressure and Setbacks
  • Relating and Networking
  • Team work and analytical skills
  • Communication
  • Problem solving
  • Initiative and enterprise – Self starter
  • Learning
  • Technology
  • Clinical reasoning
  • Time management skills
  • Resilience
  • Extremely adaptable to change
  • Ability to function well in a high performance environment with significant accountability

 

Education and Experience

  • Matric - essential
  • Medical Degree Allied Professional degree through a register University
    • Advantageous courses are Occupational Therapy, Physiotherapy, Speech Therapy, Audiology or related professions.
  • Additional courses recommended but not required: Diploma in Vocational Rehabilitation

 

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.

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