Claims Assessor

6 months ago


Pretoria, South Africa Medpharm Recruitment Full time

The purpose of this position is to ensure that all claims are assessed using the appropriate rules and is paid correctly in line with the Scheme's benefit and tariff structures.

**Duties**:

- Assessing and processing Medical Aid claims
- **Quality**:Measuring of individual error rate to ensure no costs incurred due to assessing errors made.
- **Production**:Process the average paper claims of 550 lines and 3000 EDI claim lines as determined by reporting and measuring on the new BIT administration system.
- **Operational and Department targets**:Reaching overall targets in the Department pertaining to the payment of claims.

**Requirements**:

- Grade 12 / Matric
- Experience assessing Medical Aid claims (A minimum 2 years experience)

**Job Types**: Full-time, Permanent

Pay: R1,00 - R2,00 per month

Ability to commute/relocate:

- Pretoria, Gauteng: Reliably commute or planning to relocate before starting work (required)

Application Question(s):

- What is your monthly salary expectation? (Before deductions)

**Education**:

- High School (matric) (required)

**Experience**:

- Medical Aid claims assessing: 2 years (required)


  • Claims Assessor

    7 months ago


    Pretoria, South Africa Qetello Holdings Full time

    About Our Client: Our client is a leading medical scheme based in Pretoria, dedicated to providing comprehensive healthcare benefits to its members. They are committed to innovation, quality service, and the well-being of their clients. In line with their growth and commitment to excellence, they are seeking a dedicated and experienced Claims Assessor to...


  • Pretoria, Gauteng, South Africa Santam Insurance Full time

    Job Title: Senior Motor Claim Assessor X3 Job Summary:In this role, you will be responsible for determining the quantum and merit of segmented motor claims by performing investigations, verifying the description of the event with the loss, negotiating with clients, intermediaries, and service providers, and settling claims within a delegated threshold and...


  • Pretoria, South Africa Medpharm Recruitment Full time

    A reputable Medical Aid is seeking an experienced Medical Aid Claims Assessor to join their HBM team in Pretoria. (Office based) **Requirements**: - Grade 12 - Staff/Enrolled or Registered Nurse (SANC) - Minimum 5 years’ experience as a Nursing Practitioner - Minimum 1 year experience gained in the medical funding industry - 1 year Medical Aid claims...

  • Claims Consultant

    3 weeks ago


    Pretoria, South Africa PSG Konsult Full time

    The Claims Consultant will be responsible to provide administrative assistance and support on commercial claims business. **Responsibilities**: - Liaising and providing feedback to clients of commercial claim progress - Handling client queries - Claims Management: the daily claims process from capturing received claims to processing and closing commercial...


  • Pretoria, South Africa PSG Konsult Full time

    **Job description**: The Claims Consultant will be responsible to provide administrative assistance and support in line with commercial lines insurance. **Responsibilities**: - Client face to face meetings - Liaising and providing feedback to clients of claim progress. - Handling client queries - Claims Management: the daily claims process from capturing...


  • Pretoria, South Africa Sanlam Full time

    CAREER OPPORTUNITY- Santam’s Motor Claims (North Region: Gauteng, North West, Limpopo, Mpumalanga, KwaZulu Natal) has a position available for a Motor Tow Claims Service Consultant, that will be based in Pretoria.The purpose of this position is to process all the allocated Motor Claims and make them ready for an assessor to be appointed. The CSC will be...


  • Pretoria, South Africa Sanlam Full time

    CAREER OPPORTUNITY- This career opportunity is available at Non-Motor region and the successful incumbent will be based in Centurion**WHAT WILL YOU DO?**WHAT WILL MAKE YOU SUCCESSFUL IN THE ROLE?** - Receiving instruction from Claims Service Consultant (appraisal notes & docs). - Checking completion and correctness of document and policy conditions. -...


  • Pretoria, Gauteng, South Africa Old Mutual Full time

    Job Title : Claims Negotiator: Binder SpecialistOld Mutual is seeking an experienced claims negotiator to join their team in Gauteng.We are looking for a skilled professional with 5 years of experience in group schemes claims, specifically in personal, commercial, and AGRI claims.The ideal candidate will have excellent analytical skills, advanced Excel...


  • Pretoria, South Africa Sanlam Full time

    CAREER OPPORTUNITY Santam’s Motor Claims (North Region: Gauteng, North West, Limpopo, Mpumalanga, Kwa Zulu Natal) has a position available for a Motor Tow Claims Service Consultant, that will be based in Pretoria. JOB DESCRIPTION The purpose of this position is to process all the allocated Motor Claims and make them ready for an assessor to be appointed....


  • Pretoria, Gauteng, South Africa Old Mutual Full time

    **Job Overview**Old Mutual Insure is a leading insurance company seeking an experienced Insurance Claims Specialist to join their team in Gauteng.The successful candidate will be responsible for effectively containing Binder Holder claims spend and providing exceptional service in setting a culture of best practice within mandated responsibility.Key...


  • Pretoria, South Africa Sanlam Full time

    CAREER OPPORTUNITY- Santam’s Tailored Claims Solutions department has positions available for a Non-Motor Desktop Assessor based in Centurion.**JOB DESCRIPTION** - The purpose of this position is to determine the quantum and merit of segmented non motor claims by performing investigations, verifying the description of the event with the loss, negotiation...


  • Pretoria, South Africa Santam Insurance Full time

    Job title : Motor Desktop Assessor X3Job Location : Gauteng, PretoriaDeadline : December 15, 2024Quick Recommended Links Jobs by Location Job by industries Job Description The purpose of this position is to determine the quantum and merit of segmented motor claims by performing investigations, verifying the description of the event with the loss,...


  • Pretoria, South Africa Santam Insurance Full time

    Job title : Motor Desktop Assessor X3 Job Location : Gauteng, Pretoria Deadline : December 15, 2024 Quick Recommended Links Jobs by Location Job by industries Job Description The purpose of this position is to determine the quantum and merit of segmented motor claims by performing investigations, verifying the description of the event...


  • Pretoria, South Africa Sanlam Full time

    Motor Desktop Assessor X3 Date: 13 Nov 2024 Location: Pretoria, Gauteng, ZA Company: Sanlam Group About the Company Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets,...


  • Pretoria, South Africa The South African Department of Employment & Labour Full time

    Centre: Kempton Park, stationed at Delta Heights (Pretoria) Ref No: HR 4/4/08/09 (X1 Post) Labour Centre: Germiston, stationed at Delta Heights (Pretoria) Ref No: HR 4/4/08/10 (X1 Post) **REQUIREMENTS**: Three-year tertiary qualification in Public Management/ Public Administration/ Business Management/ Business Administration/Administrative Management/...

  • Motor Assessor

    6 months ago


    Pretoria, South Africa Hollard Recruitment Full time

    **Job Advert Summary**: Helloan exciting new opportunity has just become available in our** Insure Operations**, in the** Motor Claims area**. We are looking to recruit a **Motor Assessor.** **Role Objectives**: To establish quantum of damaged vehicles for example fire damaged accident damaged and or stolen and recovered vehicles that have damages....


  • Pretoria, South Africa Motor Industry Bargaining Council Full time

    **Duties and Responsibilities** - Coordinate the customer service team with the aim of resolving queries efficiently and effectively. - Drive and motivate the customer service team to achieve targets and KPIs. - Provide recommendations to enhance current customer service processes to improve efficiency and find new ways of delivering on the industry...


  • Pretoria, South Africa Mshindi Consulting Full time

    **Duties and Responsibilities** - Coordinate the customer service team with the aim of resolving queries efficiently and effectively. - Drive and motivate the customer service team to achieve targets and KPIs. - Provide recommendations to enhance current customer service processes to improve efficiency and find new ways of delivering on the industry...

  • Motor Desktop Assessor

    6 months ago


    Pretoria, South Africa Santam Full time

    About the Company Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia. **Job Description**: The purpose of this position is to determine the quantum...


  • Pretoria, South Africa Sanlam Full time

    About the Company- Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia.- Job Description- The purpose of this position is to determine the quantum and...