Introduction:

As the Senior Group Risk Assessor, you will be responsible and accountable for overseeing, assessing, reviewing, and managing Lump Sum Disability, Critical Illness, Income Disability Claims and other claims as well as claims assessors in the environment of medical assessments within the group risk space. You will also provide support to internal teams (Actuarial and Finance) by providing reports a

Description:

THE JOB AT A GLANCE

As the Senior Group Risk Assessor, you will be responsible and accountable for overseeing, assessing, reviewing, and managing Lump Sum Disability, Critical Illness, Income Disability Claims and other claims as well as claims assessors in the environment of medical assessments within the group risk space. You will also provide support to internal teams (Actuarial and Finance) by providing reports and analysis, liaising with clients and stakeholders as well as providing solutions.

WHAT WILL YOU DO?

• Understand Group Risk Policies to ensure the fair and reasonable assessment of claims
• Managing the team
• Provide training on group risk products, disability management processes, presentation to clients etc. Training in the process including the setting up of training manuals and processes
• Assess, review, and manage Lump Sum Disability, Critical Illness and Income Disability Claims and other claims which need a medical assessment component
• Facilitate 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
• Responsible and accountable for the team and ensure that the claims are assessed as per the companys claim philosophy
• Responsible and accountable for 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 claim issues are dealt with efficiently, service level agreements with internal and external clients are met and quality control is adhered to in accordance with the audit requirements
• Trends analysis reports
• 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 and forwarded
• 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 are outstanding
• Delivering effective and consistent service and support to external clients within specified service level agreements
• Engage and retain clients within current portfolios in alignment with 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 manage financial and other company resources under your control
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

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.

Requirements:

WHAT YOU'LL BRING TO THE TABLE?

• Grade 12 qualification/Matric Certificate
• Clinical or Medically aligned degree is preferable e.g. Occupational Therapy, Physiotherapy
• 5 years claims assessing experience in Group Risk within a claims environment, with exposure to Income Disability Claims (PHI) Lump Sum Disability and Critical Illness Claims
• Experience in managing a team
• Experience in managing a portfolio of clients, providing feedback on claims trends
• 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 skills
• Have an understanding and experience of leading people and able to provide guidance and support within the work environment
• Provide guided training in company processes
• Have an understanding of 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, do what is right for the business and drive continuous improvement through innovation. Prioritize the business interests and invest in the success of the organisation by aligning effort across divisions.
• Support and gain commitment on the company objective/purpose
• 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.