Fledge Business Solutions

Claims Assessor – Claims Assessment and Management Specialist

Job Overview

More Information

Job Description

The incumbent will be responsible
and accountable for assessing, reviewing and managing Capital Disability, Dread
Disease and Income Disability claims and any other claims which need a medical
assessment component. The person will need to ensure that the standard of
decisions taken is equitable and made in accordance with the principles and
philosophy of the hiring company.

Additionally, the incumbent will
need to develop a level of competence in underwriting.The incumbent will need to ensure
that service level agreements are adhered to and that claims are assessed and
reviewed to the clients’ satisfaction.

Job Requirements

  1. Post
    Graduate medically aligned degree is preferable e.g. Occupational therapy

  2. 3-5
    yrs’ Claims assessing experience in Group Risk in a Claims environment with
    exposure to Income Disability Claims (PHI), Capital Disability and Dread
    Disease claims.

  3. Medical
    knowledge with 2-3 yrs clinical experience

  4. Insurance
    related studies especially the COP (Retirement Funds 1)/ Elements of Insurance
    is an advantage.

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