Claims Assessor

2 weeks ago

Cape Town, Western Cape, South Africa JenRecruitment Full time
A vacancy exists for a Claims Assessor in our Gap Claims Assessing Department.

Job description & duties:

  • To check and validate all GAP claim documents received and to request any outstanding documents
  • To follow the claims process and capture the claim information onto the system
  • To verify and update any client personal information changes on the system policy record
  • To assess the validity of the claim in accordance with the terms and conditions of the clients policy document and to make the relevant claim notes on the system
  • To meet your daily minimum claim targets with a high level of accuracy and within service turnaround time
  • To maintain and update your daily workflow tasks and queue
  • To ensure high priority and escalated claims as identified by management are processed within 2 hours
  • Interacting with medical aids, hospitals and medical practitioners regarding medical history and accounts required relevant to assessing the claim.
  • Other administration related functions

Skills

  • Good written and verbal communication skills
  • Good negotiation skills and effective in dealing with customers and meeting their expectations
  • Good understanding of how medical aids work and operate
  • Intermediary MS Office, especially Excel, Word and Microsoft Outlook skills
  • Good time management
  • Planning and organising
  • Works well in a team and independently
  • Coping with pressure and setbacks
  • Been proactive and using your initiative

Attitude

  • Ability to work well under pressure
  • Commitment to meet daily targets
  • Selfmotivated
  • Having a can do attitude
  • Willingness to always assist clients with their claims and requirements

Kindly note that only applicants with the following relevant experience will be considered for interview:

  • Actual Medical Aid claims processing and administration experience
  • Insurance industry experience

Salary bracket:
CTC +/- R R19000

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