Job Description

Job Summary MAIN PURPOSE OF JOB - (Job Summary) To be responsible and accountable for the administration of underwriting functions. Administering and developing the competence within the company to ensure that underwriting issues are dealt with efficiently, service level agreements with internal and external clients are met and quality control is adhered to. General Objectives To ensure that performance, processes are Job Objectives To ensure accurate and informed decisions are made with regard to member underwriting within a reasonable turnaround time To ensure that the members medical conditions are discussed with specialists to ensure that we are providing the best decision based on medicals on file To provide clients with the service as per the servicing guide and to ensure that expectations are met To adhere to reinsurer agreements To maintain service level agreements with third party service providers effective and efficient to ensure the achievement of desired goals and service level agreements; To perform at the required or optimal level (delivering the required quality and quantity work); To ensure productivity and current service levels are maintained; To create the environment to challenge existing norms and finding "best operational practices" to ensure the efficiency and effectiveness of processes and systems; To ensure all client, staff and workflow related problems are resolved speedily, accurately and within the required business rules and procedures; To ensure roles and responsibilities are clearly understood and agreed upon for the achievement of common goals and service level agreements. Purpose and outputs required of the Job Medical Underwriting Administration (underwriting needs to ensure these tasks are completed by the administrator and perform them if the administrator is not available) Responsible for the administration and maintenance of member electronic files and filing. Process the initial underwriting requirements Receive all documents and index on system Send out reminders timeously Organise the call service providers on request (nurse) Follow up daily to ensure all correspondence (emails and faxes) is professionally managed within the agreed turnaround times Follow up daily to ensure all telephone calls are professionally managed and replied to within the turnaround times Assist the underwriting team and any other team with client queries Prepare terminated scheme files for archiving 2. Medical Underwriting Ensure all documents are in receipt for medical underwriting Check the life register to ensure member is not listed for any exclusions Use the Reinsurer guidelines to ensure the underwriting principles are adhered to Make an underwriting decision Liaise with the reinsurers for advice Discuss take on agreements with risk management Communicate with the members doctor if requested to Call members on request to discuss their underwriting (requests, decisions, completion of documents) Liaise with brokers as requested to discuss any underwriting processes or queries Medical reports and medical payments Ensure all invoices are paid for services rendered If necessary, call the service provider (Doctors receptionist) to ensure we receive invoices for services rendered To ensure invoices are received and appropriately authorised for payment Prepare a payment schedule so that the finance department can prepare the payment Inform the service provider that payment has been made Call doctors receptionists to ensure medical reports are prepared and ready for collection Ensure that couriers are arranged for the collection of medicals Process all invoices for pathology Process medical payments. Insufficient attention in this area can severely reduce the profitability of the risk portfolio. Provide medical practitioner with any correspondence requested explanatory letters, copies of medical reports) 4. General outputs Ensure underwriting standards are met relative to policy wording, market practice or Company practice Assist the team to develop processes to continually improve underwriting standards Ensure that underwriting is in line with the market but also in line with Companys profit growth objective. Ensure that the standards are maintained in accordance with laid down procedures and Service Level Agreements. Assists the management by controlling costs of running the Department by monitoring the actual usage of company assets such as stationery, telephones and taking corrective action to control actual abuse of such expense items. Assists the Portfolio Manager with Internal and External Auditors reports required by them in order to ensure that financial control measures are adhered to at all times. Handles client communication in a professional and diligent fashion. Deals with clients / brokers / Sales Consultants and internal specialist departments through correspondence, telephone, e-mail, faxes. Files all documents in the correct way by scanning, sorting and filing in the appropriate way to keep the filing system in order. Assist with processes not within portfolio, when required. Communicates with the Consultant / broker / client regarding outstanding queries, either verbally or in writing, to obtain full and accurate information. At least five years past experience in underwriting area Able to work within a team Be PC Literate, preferably Microsoft based Possess good and professional communication skills preferable English Be able to work well and accurately under pressure. Organisational skills; Interpersonal skills; Post matric qualifications are optional Underwriting training Qualification Requirements Educational Requirements Matric. Qualified Nurse

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