Senior Claims Assessor at Old Mutual

Job Description

Role Overview

• Use your specialist technical medical knowledge to assess risk for business and/or specific products.
• Uses specialist technical knowledge to evaluate and manage the validity of contracts and determine and manage the liability of claims (Assessor).
• Determines, selects and accepts risk and/or liability on behalf of the organisation.
• Evaluates proposals and medical / financial evidence against business rules and practices.
• Manage a portfolio of clients which encompasses presentations, reporting and assistance with the claims process.
• Ongoing process optimisation & improvements within teams with a focus on implementing best practice in the longer term
• Acts as mentor and coach for new staff
• Collaborates effectively with others to achieve team goals
• Regular engagement with Corporate teams, providing feedback to product team on claims trends
• Accepts and lives the company values

Role Requirements

• Grade 12/Matric with Biology, Mathematics
• Completed medical / medically aligned Degree, e.g. Nursing, Occupational Therapy, Physiotherapy
• Minimum 2 years Clinical experience
• Experience in the Financial Service Industry is highly advantageous
• Specialised medical knowledge through learning or experience - essential
• Disability Claims assessment experience in a Group Assurance or Risk environment and GAP product knowledge - advantageous 
• Well developed interpersonal skills
• Strong verbal and written communication skills
• Attention to detail
• Good presentation skills
• Computer literate and proficient in MS Office programmes e.g. Word & Excel
• Have sound analytical and problem solving abilities with a focus on attention to detail
• Work effectively with internal and external colleagues and clients to accomplish organisational and team goals
• Enjoy working in a progressive environment