Disability Claims AssessorBusiness Unit: Discovery Employee Benefits
Function: Clinical
Date: 11 Oct 2024
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 Corporate & Employee Benefits Discovery Corporate and Employee Benefits is the first and only employee benefits provider to shape 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 are 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.Personal Attributes High Sense of urgency and understanding of efficient and effective client service.High EQ.Excellent communication skills, verbal and written.Action orientated.Strong Interpersonal skills.Peer relationships.Takes initiative.Decision making.Ability to work independently and within a team environment.Problem solving.Judgement.Education and Experience Qualification – Applicants must have a Bachelor's degree in Occupational Therapy, Physiotherapy or Speech Therapy or related professions, ideally with experience in Vocational Assessments.Medical Degree Allied Professional degree through a registered University.2-4 years of clinical experience.Experience in the insurance or wellness industries is preferred, but not required.Computer literate and proficient in Microsoft Office and Excel.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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