Team Leader - Disability Claims Assessment

Overview

Team Leader - Disability Claims Assessment

Discovery Corporate & Employee Benefits is the first and only employee benefits provider to shape employee behavior, creating healthier and wealthier workforces. The primary function of this role is comprised of two aspects : identifying, assessing and managing claims with internal and external stakeholders within the Disability Management process from Early Identification through the lifecycle of the claim, and leading reporting, people leadership and project leadership tasks within the Disability Claims Team. A key purpose is to add value to current processes by identifying gaps, developing processes and proposing innovative recommendations, and to serve as a subject matter expert within the team. The ultimate goal is to manage the disability claims experience through innovative and efficient claim management and to develop leadership skills supporting the management of the team as a whole.

About Discovery Corporate & Employee Benefits Discovery Corporate and Employee Benefits is the first and only employee benefits provider shaping employee behavior and healthier workforces. It is an exciting business as we reimagine retirement savings and life insurance for companies and employees.

Areas of responsibility

• Independently assess all benefits and be a key player in determining the direction and outcome of the disability portfolio. Independently provide opinions, assess, and manage disability claims within the Disability Management process, with the intention of holistically managing the claim process and experience for clients (approximately 25% of role).
• Independent discussion and presentation of cases to the reinsurer and / or Chief Medical Officer. Actively participate in claims committee, legal claims, forensics.
• Coordinate and participate in claims type assessment and consultation : SIB, ICB, CD, and Technically Complex claims; Appeals; Escalated claims; Long-term claim decisions; Ex Gratia claims; lead claims collaboration debates.
• Ensure and coordinate recruitment of effective staff. Teach, train, coach, supervise, counsel and empower staff on disability matters and processes, developing trends and breaking news affecting claims handling.
• Advocate the vision, purpose and core values of the company. Appraise staff and manage performance. Assist in development of Business Continuity Plans for emergencies.
• Customer care : ensure quality service, monitor adherence to SLAs, SOPs, policy guides, legislations, audit and compliance recommendations; utilize customer perception surveys to measure satisfaction.
• Manage broker perception through resolution of queries; build effective relationships with internal and external parties.
• Educational role : serve as a subject matter expert on disability claims; educate clients and employees about disability products, processes and requirements.
• Product and system enhancements : contribute to developing better disability claim assessment and management systems, processes, products, and guidelines; identify gaps and propose improvements to increase efficiencies and quality.
• Support key reporting, people leadership and project leadership tasks within the disability team.
• Monthly statistics analysis and identification of operation priorities to address.
• Log QCs / Jira on an ad hoc basis and log IQS breaches on Paradigm.
• Development and support of project work to improve processes.

Personal attributes and skills

Education and experience

EMPLOYMENT EQUITY : The 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.

Seniority level

Employment type

Job function

Note : This posting focuses on the role responsibilities and qualifications. The content has been refined for clarity and readability; extraneous job-feed items have been omitted.

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