Claims and Underwriting Administrator - SandtonFull job descriptionBusiness Unit: Discovery Employee BenefitsFunction: Claims AdministrationDate: 10 Apr 2024Achieve more than YOU BELIEVE Discovery Corporate & Employee BenefitsClient Care Team: Claims and Underwriting AdministratorAbout DiscoveryDiscovery’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 BenefitsDiscovery Corporate Employee Benefits is the first and only employee benefits provider to be shaping 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 is brought to companies and employees. Our goal is simple – to reimagine the way we deliver benefits to South African employees and companies. We have the ability and responsibility to shape employee behaviour. In doing so, we will create healthier and wealthier workforces and move South Africa forward.Key Purpose of the roleAssisting the underwriters with general administration related to underwriting. Ensure brokers are well informed by providing accurate information to them in order to adequately support clients. Compile underwriting status reports. Provide or receive half cost medicals from other insurers. Ensure claim assessments and payment of lump sum benefits (Funeral, death, SIB and ICB) payments.Principle AccountabilitiesEnhance group risk revenue and profit streams to meet business objectives through the following:Claims:Compile claims reports for brokers from SFE and CompassPre-assess or review disability claim applications as per processManage claim related queries and provide the client with feedback thereofReceive claims from indexing department for assessment of the funeral and death claims - member; child or spouse claims as well as extended family members. Assess each claim by verifying claim details against standard claims requirements. Liaise with Broker should documentation not be in orderShould discrepancies be picked up, refer the documentation to the Forensics Department. Ensure regular follow-up until Forensics provide an investigation outcomeOnce all documentation has been received, set up payment on the system for verification by second Assessor and AuthoriserReceive claims for verification (second assessing) and authorizingIssue payment letters and/or claims decision letters to Brokers once payment has been approved Underwriting:To send medicals requirements requests to brokers/SC in order to be completed by member for underwriting members’ over the acceptable limitLink the received completed medicals to the system and allocate to the underwriters for a decisionEnsure all documents submitted are correct and completed in full. Where documents are missing, source the documents from Meditech or other PathologistsOnce all documentation is attached on SFE, complete audit for Member and move it to the UnderwritersCompile underwriting admin reports for brokers from SFE and CompassInvestigate reasons for anomalies on any underwriting admin process and troubleshoot. Look out for members that need decisions to be re-appliedDeal with escalated calls or queries to ensure high quality.Personal AttributesResilientAdaptable/ flexibleDependable and ReliableHigh level of IntegrityTenacitySelf-starter with a high attention to detail and be able to multi-task.Good at follow throughExceptional ability to communicate written and orally.Problem solving and solution focused.Analytical – interpretationBuilding relationshipsCoping with pressureTime-Management and Organizational SkillsMust be team orientated, willing to assist other team members in the office.Compassion: 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 skillsEducation and ExperienceMatric - EssentialRelevant Industry Qualifications – AdvantageousMS Office experience especially Excel and Compass- EssentialGroup Life/Risk Insurance experience- Essential1 to 2 years working experience within a Group Life Administration environment Employment EquityThe 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 EMPLOYMENT EQUITYThe 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.
