Claims Assessor / Disability Claims Assessor. Qualified OT Occuptional Therapists (Clinical exp)

The incumbent will be responsible and accountable for assessing, reviewing, and managing Capital Disability, Dread Disease and Income Disability Claims and other claims which need a medical assessment component.  The person will need to ensure that the standards of decisions taken is equitable and made in accordance with the principles and philosophy of the Company.  The incumbent will need to ensure that service level agreements are adhered to and that claims are assessed and reviewed to the clients''satisfaction.

 KEY OUTPUTS

• Responsible and accountable for disability and dread disease claims
• Assess all disability and dread disease claims
• Liaise with the relevant role players for claims needing active management
• Maintain the 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 brokers 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
• Assist with processes not within portfolio when required

QUALIFICATION AND EXPERIENCE

• Matric
• OT Degree  Occupational Therapy,
• Experience as a claims Assessor environment with exposure to Income Disability Claims (PHI) Capital Disability and Dread Disease Claims would be an advantage or clinical experience

PERSONAL ATTRIBUTES

• Integrity
• Assertive
• Customer Centricity
• Ability to maintain confidentiality
• Ability to work under pressure
• Patience and empathy
• Accuracy
• Ability to work independently

SKILLS

 Clinical experience essential - corporate group life would be an advantage

• Excellent Knowledge of Microsoft Office
• Excellent Telephonic skills
• Excellent interpersonal skills
• Good written and verbal communication