Claims Assessor at Discovery Limited

Key Purpose

• The main purpose is to assess Income Protection (IP) claims in line with current UK industry best practice and within the required service levels.

Areas of responsibility may include but not limited to:

The successful applicant will be responsible for but not limited to the following job functions:

• Medical and financial assessment of Income Protection claims.
• Assessing the contractual validity of a claim.
• Identifying possible fraud, misrepresentation and pre-existing conditions.
• Liaising with internal and external stakeholders to reach claim decision.
• Provide input into product development and system enhancements
• Complaint resolution
• Support team through knowledge sharing (medical, technique)
• Coaching of administrators

Personal Attributes and Skills

• Deciding and initiating action
• Working with People
• Able to work unsupervised and to take initiative
• Adhering to Principles and Values
• Presenting and Communicating Information
• Conflict handling and resolution
• Collaboration and team work
• Learning and Researching
• Delivering Results and Meeting Customer Expectations
• Following Instructions and Procedures
• Adapting and Responding to Change
• Coping with pressure and setbacks
• Achieving Personal Work Goals

Education and Experience:

Education

• Matric/Grade 12 is essential
• A minimum of 3 years prior experience within a claims environment in the life insurance industry is essential.
• COP (Certificate of Proficiency) in life insurance would be advantageous.
• Medical degree or diploma would be advantageous.

Knowledge:

• Microsoft Office skills, i.e. Outlook, Excel and Word are mandatory.
• Intermediate knowledge of the Life Insurance Industry.
• Experience within the UK Life Claims environment would be advantageous.
• An intermediate to advanced understanding of Medical conditions and diagnoses
• An intermediate to advanced level of Communication Skills (verbal & written)