Introduction
Through our client-facing brands Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.
Disclaimer
As an applicant, please verify the legitimacy of this job advert on our company career page.
Role Purpose
Ensure accurate and compliant underwriting decisions through thorough investigation, alignment with guidelines, analysis of underwriting criteria, and maintaining quality and compliance standards.
Requirements
2-3 years practical experience in Clinical Health Risk Management and or equivalent relevant experience Health underwriting and familiarity with nondisclosure processes, principles, and terminology Financial/Insurance industry (desirable)
Duties & Responsibilities
PROCESS
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Conduct thorough medical assessments and apply clinical knowledge in a professional manner, ensuring accuracy and precision.
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Provide expert advice and support in underwriting, nondisclosure, and claims for moderate and complex assessments, effectively mitigating organisational risk.
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Make precise nondisclosure decisions for beneficiaries and dependents who fail to disclose health conditions upon rejoining the medical aid, adhering to the Medical Scheme Act, underwriting policy, and established standards, protocols, and guidelines.
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Implement conditionspecific waiting periods following nondisclosure investigations. Investigate client queries within agreed service levels, delivering timely feedback to ensure utmost client satisfaction.
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Review claims and authorization history to identify any additional nondisclosed health conditions, enhancing accuracy in underwriting decisions.
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Develop and maintain productive relationships with peers and stakeholders, fostering collaboration and effective communication.
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Establish and uphold underwriting policies and guidelines, ensuring consistency, defensibility, and adherence to industry standards.
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Manage nondisclosure escalations within specified turnaround times, resolving issues promptly and efficiently.
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Foster positive relationships and partnerships with clients and key stakeholders, promoting trust and mutual growth.
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Efficiently plan, administer, and process beneficiaries health information in alignment with performance objectives, ensuring data integrity and compliance.
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Collaborate with stakeholders in conducting underwriting and medical research in targeted areas, facilitating informed decisionmaking.
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Interact with clients competently and professionally, maintaining highquality standards and delivering exceptional service.
CLIENT
- Establish and nurture relationships with clients, internal teams, and external stakeholders, fostering strong connections and mutual trust.
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Meet and exceed service level agreements applicable to clients and stakeholders, effectively managing and surpassing client expectations.
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Provide recommendations to enhance client service and ensure fair treatment within the realm of responsibility, promoting satisfaction and loyalty.
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Monitor turnaround times and quality standards, proactively resolving issues to enhance client service delivery.
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Provide accurate and timely resolution of client queries, utilising feedback to drive process improvements and optimise client service.
PEOPLE
- Build strong relationships, share specialised knowledge, and demonstrate effective leadership, fostering collaboration and positive engagement.
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Continuously develop industry expertise and relevant knowledge, applying acquired insights to drive excellence.
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Positively influence and manage change, offering support and guidance when required, fostering adaptability and resilience.
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Foster a culture of innovation by involving colleagues and staff in the development and implementation of new ideas, driving continuous improvement.
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Contribute to workcentric thinking, productivity, service delivery, and quality management, promoting a highperformance work environment.
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Take ownership of driving career development, proactively pursuing growth opportunities and selfimprovement.
FINANCE
- Implement and provide input into governance processes, systems, and legislation in the specialised area, ensuring compliance and efficiency.
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Escalate unresolved policy and governance compliance issues for investigation and resolution, promoting accountability and risk mitigation.
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Contribute to risk identification processes and communicate recommendations in the appropriate forum, enabling proactive risk management and mitigation.
Competencies
Examining Information: Analyses and processes information asks probing questions strives to find solutions to problems,
Documenting Facts: Writes fluently when documenting facts understands arguments logically focuses on finding facts,
Interpreting Data: Interprets data rationally by quantifying issues applies technology as a means to evaluating data evaluates information objectively,
Interacting with People: Is lively and projects enthusiasm is talkative in making contact is focused on interacting and networking with people,
Articulating Information: Is articulate in giving presentations is eloquent and explains things well projects social confidence when articulating information,
Making Decisions: Is determined and decides on actions willingly assumes responsibility is definitive and stands by own decisions,
Meeting Timescales: Is target focused and meets deadlines is punctual and keeps to schedule is reliable in finishing tasks,
Upholding Standards: Behaves ethically and justly is discreet and maintains confidentiality meets commitments by acting with integrity.
