GAP Claims Assessor
4 months ago
A recent professional profile photo is to accompany your application
EMPLOYMENT TYPE : Permanent
SECTOR : Finance
BASIC SALARY : R16,000
START DATE : A.S.A.P / Immediate
REQUIREMENTS:
- 2 years experience in a similar role
- Insurance industry experience (essential)
- Medical Aid claims processing and administration experience (essential)
- Ability to work well under pressure
- Commitment to meet daily targets
- Self-motivated
- Having a can do attitude
- Good written and verbal communication skills
- Good negotiation skills
- Good understanding of how medical aids work and operate
- Intermediary MS Office, especially Excel, Word and Microsoft Outlook skills
- Good time management skills
- Works well in a team and independently
- Copes well with pressure and setbacks
- Pro-active and using your initiative
DUTIES:
- Check and validate all GAP claim documents received and to request any outstanding documents
- Follow the claims process and capture the claim information onto the system
- Verify and update any client personal information changes on the system policy record
- 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
- Ensure a clients claim expectation is adequately addressed and managed by applying the TCF principals and effectively communicating with the client or broker regarding their claim
- Meet your daily minimum claim targets with a high level of accuracy and within service turnaround time Maintain and update your daily workflow tasks and queue
- Ensure high priority and escalated claims as identified by management are processed within 2 hours Interact with medical aids, hospitals and medical practitioners regarding medical history and accounts required relevant to assessing the claim
HOURS:
- 08:00 17:00 Monday - Friday
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