Claims Assessor

2 weeks ago

Cape Town, 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 pro-active and using your initiative

**Attitude**
- Ability to work well under pressure
- Commitment to meet daily targets
- Self-motivated
- 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 +/- R16000 - R19000

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