That final layer of polish and execution is what gets you hired. If you don't have that, you get eliminated immediately. Nobody will ask about your process or your wireframes if your resume gets tossed in the trash bin. You'll never have a conversation about the organizational mission and how it relates to the product if you never get called back for an interview.
If you go in with Paul's first three steps (like I did) and you're lucky enough to talk to someone who doesn't eliminate based on that all-important fourth step of visual design, you'll find yourself in disagreement. There's 8,000 ways to build a product, and chances are your method simply won't line up with theirs.
Meanwhile, there's also 8,000 ways to make something look good, but all of those ways end up beautiful. It's hard to argue about solid visual design, even if it doesn't fit your particular style or tastes.
You can get away with subpar visual design skills at your own startup, like I did, but don't ever expect to get hired without developing those skills. They're more important than the other three combined.