Description:
Summary:
The Disability Claims Assessor is responsible for accurately assessing, investigating, and managing long-term insurance claims, including disability and critical illness claims. This role requires strong analytical skills, attention to detail, and the ability to engage with various stakeholders to ensure fair and efficient claim outcomes. The ideal candidate will have experience in Group Risk claims assessment and a passion for vocational rehabilitation.
What to Expect:
Accurately assess, investigate, and manage long-term insurance claims, including disability and critical illness claims Prepare draft minutes for the Claims Management Committee (CMC), outlining assessment findings and reasoning Assist in organizing and preparing for weekly CMC meetings as required Liaise with brokers, employers, and members to gather necessary information and provide updates Actively present claims and participate in CMC meetings Follow up on action items from CMC meetings, liaising with reinsurers and other stakeholders as necessary to implement decisions and manage claims Coordinate with appropriately qualified independent service providers for external examinations and appointments Draft clear and concise letters communicating assessment decisions Ensure a strong understanding of the claims processing and payment procedures Lead and contribute to key projects within the claims team, including vocational rehabilitation and early intervention initiatives Respond to stakeholder queries efficiently and professionally within established turnaround times Provide support to service providers, offering clarification and assistance as needed Maintain timely, accurate, and complete data entries on all systems Adhere to established procedures and workflows, ensuring compliance with turnaround times Deliver high-quality service to both internal and external stakeholders, safeguarding their interests Ensure that claim assessments align with the companys values and standards of decision-making Foster a collaborative and supportive team environmentWhat You'll Bring:
Qualifications and Experience
Matric or equivalent qualification Relevant Medical Qualification (e.g., Occupational Therapy, Physiotherapy, Nursing, etc.) Minimum of 2 years experience in assessing Group Risk claims, with a strong background in disability claims. Exposure to lump sum claims such as Life, Capital Disability, and Critical Illness is an advantageCompetencies
Excellent interpersonal and communication skills, both verbal and written Strong understanding of Long-Term Insurance and Group Risk products Familiarity with Vocational Rehabilitation and
07 May 2025;
from:
gumtree.co.za