Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (2024)

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Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (2)

Senior Medical Claims Assessor

Bidvest Life Durban, KwaZulu-Natal, South Africa

Bidvest Life Durban, KwaZulu-Natal, South Africa

5 days ago 90 applicants

Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (4) Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (5) Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (6)

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Job Purpose / Summary

To assess all income and disability claims (medical claims) in line with policy terms, company standards and claims philosophy

Job Content & Main Responsibilities

1. Assessment of all income and disability claims in line with policy terms and claims philosophy

  • Review all documents submitted in terms of income protection, critical illness and permanent disability claims
  • Formulate a decision on each claim
  • Liaise with re-insurance partners as required
  • Process payment on the claim
  • Communicate the decision verbally and / or in written format to all parties

2.Case management

  • Formulate a rehabilitation or case management plan on suitable cases to facilitate recovery and return to work
  • Liaise with the claimant and rehabilitation specialists

3.Client relationships

  • Communicate claim requirements to the relevant parties as required
  • Communicate claims decisions to clients
  • Communicate with claimants on their rehabilitation program

4.Support Medical Claims Assessors

  • Assist Medical Claims Assessors with opinions on claims as required
  • Review and sign-off decisions formulated by Medical Claims Assessors as required

Job Requirements

Minimum Qualifications

  • Matric
  • Tertiary qualification in Occupational Therapy, Physiotherapy, Biokinetics or Chiropractic

Minimum Experience

  • 2 years of clinical experience advantageous
  • 5 to 8 years of experience in the assessment of income protection and disability claims in the Long-Term insurance industry
  • 2 years experience in managing a team
  • Advanced computer literacy

Competencies

  • Advanced understanding of medical conditions, treatment protocols and rehabilitation programmes
  • Advanced understanding of functional impairment and how different medical conditions would affect ability to work
  • Advanced analytical and problem-solving skills
  • Attention to detail
  • Excellent verbal and written communication skills
  • Ability to manage conflict
  • Ability to work under pressure at a fast pace

Occupational Level (choose one)

  • Professionally Qualified and experienced specialists / mid-management: Professional knowledge of sub-discipline or discipline. Provide input in the formulation of Organisational/Functional Unit business plans. Formulate and implement departmental/team plans that will support the BU business plans. Optimization of resources (finances, people, material, information and technology) to achieve given objectives in most productive and cost-effective way.

  • Employment type

    Full-time

Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (7) Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (8) Bidvest Life hiring Senior Medical Claims Assessor in Durban, KwaZulu-Natal, South Africa | LinkedIn (9)

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