At Liberty, we employ more than 6 000 people across 7 businesses in 18 African countries. Every day, our employees grow their knowledge by working with diverse groups of people who specialise in a wide range of skills across insurance, asset management, investment and health products. We continually seek to engage, develop, recognise and reward the people who make our business great.
Purpose
To provide specialist advice and support ensuring that claims are paid out as accurately and timeously as possible, through the execution of predefined objectives as per agreed standard operating procedures (SOPs). The core focus of this role will also be to identify policy definitions, request requirements (i.e. from Doctors and Clients), that have not been received to assess disability, income and dread disease medical claims.
Minimum Experience
5 – 8 years experience in a similar environment
Minimum Qualifications
A relevant Degree in Nursing, Occupational Therapy,Physiotherapy OR similar.
Critical Job
The followingrequirements are critical to this role:
- Minimum of 5 years relevant Medical claims experience, in assessing Living Benefits, i.e. Income Claims, Disability and Dread Disease Claims.
- The successfulapplicant will be responsible for the following and it is therefore critical that he/she has the following relevant experience as per below:
- Synopsise medical, occupational and financial information at hand;
- Consult with Doctors, Reassurers, Underwriters and Management on various claims decisions;
- Letter writing and formal decision and communication to Clients and FA’s thereof;
- Experience in dealing with complex claims;
- Keeping customers informed on every step of the claims process.
Outputs
Process
- Adhere to identified best practices in providing advice and support from a specialist perspective.
- Independently, fairly and effectively assess and manage risk claims within relevant authority limits.
- Process special claims as and when they occur and provide support to resolve relevant concerns related to claims.
- Accountable for the execution of specialised work including the improvement of quality, standards and outputs within defined work routines and operating procedures.
- Proactively solves problems, determines root-cause and applies solutions in line with guidelines and providing the necessary information to solve problems related to area of specialisation.
- Plan for own task execution and advises on improvements related to area of specialisation.
Customer
- Provide support to ensure the effective resolution of customer queries in order to promote customer satisfaction and retention.
- Ensure that workflow items, escalations and queries are resolved within SLA.
- Provide advice and support in area of accountability to ensure that identified solutions and recommendations are appropriate and effective.
- Ensure own understanding and adherence to customer service delivery and Treating the Customer Fairly (TCF) principles to provide specialist support and guidance.
Finance
- Adhere to specified standards, policies and procedures to prevent potential losses/wastage related to the area of specialisation.
Learning and Growth
- Contribute positively to own area-specific knowledge improvement associated with area of specialisation.
Governance
- Comply to set governance and compliance procedures and processes related to an area of work and continuously identify, rectify and escalate risks where necessary.
Competencies
Liberty Values
Technical Competencies
- Claims notification and investigation (Intermediate)
- Research and Information Gathering (Basic)
- Reporting and Interpretation (Basic)
- Claims knowledge (Intermediate)
- Customer Advice (Technical) (Basic)
- Insurance products and services (Intermediate)
- Customer Relationship Management (Basic)
Behavioural Competencies
- Professional/Technical learning (Basic)
- Analytical Thinking (Proficient)
- Organisation and Attention to Detail (Basic)
- Interpersonal Effectiveness (Basic)
- Problem Solving and Analysis (Basic)
- Teamwork and Cooperation (Basic)
- Customer service orientation (Basic)
- Communicating with Impact (Basic)
- Customer Orientation (Basic)
We put our knowledge and insight acquired over the past 60 years, to serving a pan-African market of the future. Liberty has received its eighth certification as a Top Employer from the Top Employers Institute. See details here link