THE JOB AT A GLANCE
As the Group Risk Assessor, you will be responsible and accountable for assessing, reviewing, and managing Lump Sum Disability, Critical Illness, Income Disability Claims and other claims which need a medical assessment component. You will also provide support by liaising with clients and stakeholders as well as providing solutions, understanding Group Risk Policies to ensure the fair and reasonable assessment of claims. Facilitating case management programmes where applicable to assist claimants in their return to work. Ensure that the standards of decisions taken is equitable and made in accordance with the principles and philosophy of the Company. Ensure that service level agreements are adhered to and that claims are assessed and reviewed to the clients' satisfaction.
WHAT WILL YOU DO?
Responsible and accountable for disability and critical illness claims
Assess all disability and critical illness claims
Liaise with the relevant role players for claims needing active management
Maintain competence within the Company to ensure that disability claims issued are dealt with efficiently, service level agreements with internal and external clients are met and quality control is adhered to according to the audit requirements
Meet regularly as requested with intermediaries and their clients to discuss relevant claims issues and resolve any outstanding queries
Ensure that good knowledge of policies, terms and conditions and their application is maintained
Ensure claim standards are met relative to policy wording, market practice and the Company practice
Ensure that records are maintained
Assist with processes not within portfolio when required
Provide administrative support for a variety of Claims practices (Internal Process)
Contribute to the overall team achievement of set team targets through excellence
Answer and provide first time resolution and quality driven responses to all correspondences
Adhere to the standard operating procedures when communicating with clients through recording and updating of calls, update query with actions taken and escalate to the relevant assessor on the claims system
Engage with clients in a client centric manner (Client Services)
Keep client informed (verbally and/or in writing) if any unresolved queries is outstanding
Delivering effective and consistent service and support to external clients within specified service level agreements
Engaging and retaining of clients within their current portfolios aligned to the Treating Customers Fairly principles
Make recommendations to improve client service and fair treatment of clients within area of responsibility
Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service
Self-management and teamwork (People)
Develop and maintain productive and collaborative working relationships with colleagues, peers and stakeholders
Continuously develop own expertise in terms of professional, industry and legislation knowledge
Contribute to continuous innovation through the development, sharing and implementation of new ideas
Take ownership for driving your career development
Contribute to financial controls and planning (Finance)
Identify solutions to enhance cost effectiveness and increase operational efficiency
Responsibly managing financial and other company resources under your control
Provide input into the risk identification processes and communicate recommendations in the appropriate forum
Understand how the business operates, what the key issues and risks are that drive business outcomes
Anticipate, meet and exceed client's needs by creating long lasting relationships that support the client value proposition, supports their financial wellness and ensures client centricity
Actively participate in change, does what is right for the business and drives continuous improvement through innovation. Prioritize the business interests of the company and invest in the success of the group by aligning efforts across divisions
Support and gain commitment for the company objective
Manage self and relationships with others effectively and provide perspective in difficult situations
Be sensitive to individual and cultural similarities and differences, demonstrate humility and an openness to engage people from diverse backgrounds and cultures to the mutual benefit of all parties concerned.
WHAT WILL YOU GET IN RETURN?
We offer great opportunities for personal and professional development in a stable company that is 130 years strong. The role comes with a competitive salary package and various benefits. Furthermore, you will be part of a dedicated group of colleagues who value teamwork and collaboration.
Turnaround time
The shortlisting process will only start once the advert due date has been reached. The time taken to complete this process will depend on how far you progress within the recruitment process and the availability of our managers. Kindly note that should you not receive a response within 21 days, please consider your application unsuccessful.
Our Commitment to transformation:
In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets, preference may be given, but is not limited, to candidates from under-represented designated groups.
WHAT YOU'LL BRING TO THE TABLE?
Grade 12 qualification/Matric Certificate
Medically aligned degree is preferable e.g. Occupational Therapy, Physiotherapist
3 to 5 years claims assessing experience within Group Risk as a claims environment, with exposure to Income Disability Claims (PHI) Lump Sum Disability and Critical Illness Claims
Experience in managing a portfolio of clients, providing feedback on claims trends
Clinical experience essential – Within a Corporate Group Life environment would be an advantage
Excellent Knowledge of Microsoft Office
Excellent Telephonic skills
Excellent interpersonal skills
Good written and verbal communication skills
Integrity
Assertiveness
Customer Centricity
Ability to maintain confidentiality
Ability to work under pressure
Patience and empathy
Accuracy
Ability to work independently
Ability to work within a Team.
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