PPS Insurance has a vacancy for a Junior PI Assessor at our Head Office in Johannesburg. This position is for an individual who has a keen interest in the field of claims assessing. This is a junior position where the assessor has the necessary qualification and or less than 2 years' experience in assessment of sickness or income protection claims.
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Minimum Requirements
Matric
Medical qualification (Physiotherapist or Occupational Therapist or BA Psychology; Behavioural Science/Sociology or related)
1 - 2 years experience in the assessment of insurance claims is advantageous
Working experience in a medical aid environment or medical insurance environment would be an advantage
Data analytics would be an advantage
Basic computer skills.
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Duties and Responsibilities
Perform administration tasks related to the assessment of long term claims.
Assess and valid date short term and long term claims.
Follow claims communication matrix.
Synopsise available information.
Communicate with brokers, members and internal staff when the need arises to discuss the progress of claims, claims process, confirm information or request additional information.
Ensure claims are assessed in line with the documented processes.
Prepare cases for discussion with Team Manager/medical officers when required.
Prepare cases for presentation at MOC.
Able to read and understand reports.
Ability to self-manage time and work requirements.
* Apply medical knowledge to the assessment of claims.
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