Senior Medical Assessor

at  PPS Recruitment

JOB ADVERT SUMMARY

The role will be responsible for assessing and managing claims with adherence to policy terms and conditions. The successful incumbent will be ccountable for claims processes and procedures and where necessary help with formulating return to work plans or engaging the services of accredited professionals. Assist in improving the process and bring in a level of innovation to ensure an efficient claims process for our members.

EDUCATION:

• Matric (Grade 12)
• Degree in Occupational Therapy or Physiotherapy or equivalent

EXPERIENCE:

• 5 – 6 years’ working experience essential, 4 of which must be in the Life Insurance Industry.
• Assessment of income protection, occupational and functional disability, dread disease and life at a senior level essential.
• Case management experience advantageous with proven track record, preferred.
• Experience in the use of AMA Guides to assess Impairment (Whole person Impairment), essential.
• Knowledge of non-disclosure process and validation preferred.
• Experience in corresponding with clients verbally and in writing.

KNOWLEDGE AND SKILLS:

• Laws and regulations that govern the long-term insurance industry.
• Formulation of case management programs and plans.
• Good presentation and report writing skills.