Ill Health Assessor

Vacancy Details
Employer:
Motor Industry Fund Administrators
Job Description
Applicant would be responsible for the assessment of and for providing recommendations on Disability benefit claims, ensuring that these are processed efficiently to enable the Operations department to pay benefits without undue delay so that an excellent and professional service is rendered to claimants.
Duties and responsibilities of the job
The successful applicant will be responsible for but not limited to the following broad job functions
- Assists the Manager with the evaluation of Disability claims for validity
- Maintains a network of medical practitioners across South Africa who assist with disability cases
- Identifies or sources relevant medical practitioners where a medical opinion is required by the Board
- Make appointment and/or allocates the task to a Risk Benefits Administrator of making an appointment, with a suitable, qualified medical practitioner whose practice is accessible to the member
- Refers relevant reports and information to medical consultants (e.G., OTs), where medical assessments are required
- Communicates with members regarding the referral and the progress of a claim
- Informs members in writing of reason when disability claims are declined
- Deal with problematic clients to the resolution of the query/issue
- Attend to
Telephonic queries from members and/or MIBCO staff
- Work together as a team by regularly updating comments, regular follow-up of pending, and assisting colleagues if needed.
- Conduct monthly check-ins with team members.
- Coaching and mentoring team members.
Knowledge and skills
- Knowledge of POPIA, FICA and FAIS
- MS Office Suite ? Word &
Excel
- Good understanding of the Retirement Fund Administrator Business requirements
- Good understanding skills of the rules of funds and how they are applied in situations
- Computer Literacy
- Telephone Etiquette
- Time Management
- Attention to Detail
Minimum requirements and experience
- A minimum of 2-years? experience as a Claims Administrator (Withdrawals;
Ill Health;
Death;
Retirements;
Unclaimed;
Surplus, Divorce, maintenance and withholding matters.
- A minimum of 2 years? experience in checking claims and releasing payments
- Experience and understanding of financial calculations (e.G., tax
- and tax-free portions)
- Knowledge of the Pension Funds Act, more specifically Section 13A, 15 &
Section 37 A, C &
D
- Everest system
- Understand the role of the Bargaining Council and Customer Service in financial services.
- Diploma/Degree in Occupational Therapy, Physiotherapy, or related qualification ? Mandatory
- Everest system knowledge -advantage