Disability Claims Assessor

Discovery; Johannesburg; On-site; ZAR 200,000 - 300,000; Full time

Job summary

A leading healthcare provider in Johannesburg seeks a Disability Claims Manager to oversee the claims process and enhance client experiences. Ideal candidates should have a relevant bachelor's degree and 2-5 years of clinical experience. Strong communication and analytical skills are essential. This role involves managing claims, ensuring compliance, and providing leadership within the team while fostering professional relationships with clients.

Qualifications

• Bachelor's degree in occupational therapy, Physiotherapy, or Speech Therapy.
• 2 - 5 years of clinical experience.
• Insurance or wellness industry experience preferred.

Responsibilities

• Manage disability claims from start to finish.
• Communicate effectively with stakeholders.
• Ensure compliance with company policies.

Skills

High sense of urgency

Communication skills

Problem solving

Analytical skills

Compassion

Time-management

Education

Bachelor's degree in allied health profession

2 - 5 years of clinical experience

Insurance experience

Tools

Microsoft Office

Excel

Job description

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 of the role

The primary function of this role is comprised of two aspects, the first is to identify, assess and manage claims with internal and external stakeholders within the Disability Management process from Early Identification through the lifecycle of the claim. The second is to take on key reporting, people leadership and project leadership tasks within the Disability Claims Team. A key purpose is to add value to current processes by identifying gaps, developing processes and proposing innovative recommendations that will impact efficiencies and the quality of work produced. You will therefore need advanced technical skills, particularly in excel, excellent communication skills, sound clinical knowledge, and be comfortable working to extremely tight deadlines. The ultimate goal of the role is to manage the disability claims experience through innovative and efficient claim management as well as develop people leadership skills and functional leadership skills providing key support to the management of the team as a whole.

Areas of responsibility

• Ensure the effective validation and assessment of all disability claims according to company policy whilst having a client centered 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 with 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
• Create and Implement initiatives and opportunities for change and improvement – within the team, business, and self.
• Maintains and develops professional relationships with internal and external clients and ensures the best communication with customers using a client centric approach.
• Seeks and receives the advice and input of others
• Seeks involvement in projects of varying subject matter
• Participate in personal and professional development activities, training, and courses
• Additional ad hoc preparations for Audits (Internal and External), Compliance audits and TC

Personal Attributes and Skills

The successful candidate must demonstrate the following competencies:

• High Sense of urgency and understanding of efficient and effective client service
• High EQ
• Self-starter with a high attention to detail and be able to multi-task
• Good at follow-through
• Exceptional ability to communicate written and verbally
• Problem solving and solution focused
• Analytical – interpretation
• Building relationships
• Coping with pressure (deadlines)
• Time-Management and Organizational Skills
• Must be team orientated, willing to assist other team members in the office
• Compassion: a successful candidate will be working with people who are sometimes in dire situations or going through difficult transitions. Must be compassionate to their situation and working with them in a positive way
• Outstanding customer service skills
• Action orientated
• Career ambition
• Takes initiative
• Decision making
• Ability to work independently and within a team environment
• Problem solving

Education and Experience

• Allied Professional degree through a registered University
• Qualification – Applicants must have a bachelor’s degree in occupational therapy, Physiotherapy or Speech Therapy or related professions, ideally with experience in Vocational Assessments
• Additional courses recommended but not required: Diploma in Vocational Rehabilitation
• 2 - 5 years of clinical experience
• 2 - 5 years insurance 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.