Gap Claims Assessor

1 week ago


Cape Town, South Africa Guardrisk Full time

**Introduction**
- A vacancy exists for a Claims Assessor in our Gap Claims Assessing Department.

**Disclaimer**
- As an applicant, please verify the legitimacy of this job advert on our company career page.

**Role Purpose**
- Claims administrative responsibilities in respect of GAP Short Term Insurance Products.
- Ensuring that the principles and outcomes of TCF (Treating Customers Fairly) are practiced and achieved in all duties performed and services provided to Zestlife customers.

**Requirements**:

- 2-3 Years experience within a medical claims assessing role
- Matric Qualification
- Good understanding of how medical aids work and operate
- 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

**Duties & Responsibilities**
- 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 to assess the claim.
- Other administration-related functions

**Competencies**
- Intermediary MS Office skills, especially Excel, Word and Microsoft Outlook
- Good time management
- Planning and organising
- Works well in a team and independently
- Coping with pressure and setbacks
- Being pro-active and using your initiative
- Ability to work well under pressure
- Commitment to meet daily targets
- Self-motivated
- Having a can-do attitude


  • Gap Claims assessor

    2 days ago


    Cape Town, Western Cape, South Africa Measured Ability Full time

    Applicants must have a thorough understanding of medical aid operations or insurance policy administration and operations.Matric.Responsibilities: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 into the system.To verify and update any client...

  • Gap Cover Assessor

    3 weeks ago


    Cape Town, Western Cape, South Africa Kontak Recruitment Full time

    Gap Cover Assessor (JB5016)Cape Town, Western Cape R20 000 - R28 000 CTC per month Permanent Our client, a prominent provider of innovative and flexible solutions centered around health, wellness, and financial security, is seeking a gap cover assessor to join their team. This position involves validating claim documentation, managing communication with...

  • Gap Cover Assessor

    2 weeks ago


    Cape Town, Western Cape, South Africa Kontak Recruitment Full time

    Gap Cover Assessor (JB5016)Cape Town, Western Cape R20 000 - R28 000 CTC per month PermanentOur client, a prominent provider of innovative and flexible solutions centered around health, wellness, and financial security, is seeking a gap cover assessor to join their team.This position involves validating claim documentation, managing communication with...

  • Claims Assessor

    1 week ago


    Cape Town, South Africa JenRecruitment Full time

    A vacancy exists for a Claims Assessor in our Gap Claims Assessing Department. (Claremont Cape Town) **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...

  • Claims Assessor

    1 week ago


    Cape Town, South Africa Kontak Recruitment SA Full time

    Cape Town, Western Cape - Administrative **Claims Assessor (JB4315)** **Claremont, Cape Town, Western Cape** **R16 000 - R19 000 CTC per month based on experience** **Permanent** A leading provider of insurance solutions, dedicated to delivering exceptional service and peace of mind to their clients and strives to exceed expectations by consistently...

  • Claims Assessor

    3 days ago


    Cape Town CBD, South Africa Rand Mutual Admin Services Full time

    Introduction: As a Claims Assessor, you will be reporting to the Team Leader: Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. Description: THE JOB AT A GLANCE As a Claims Assessor, you will be reporting to the Team Leader:...

  • Claims Assessor

    2 weeks ago


    Cape Town, South Africa Lion of Africa Life Assurance Company Full time

    **Job description** **Main Purpose** One of the leading firms in the financial industry Lion Life in the Cape Town area is now hiring a skilled Claims Assessor. If you are hard-working and dedicated, Lion Life is an excellent company for you to grow your career. **Role Responsibility**: - Capturing all claims received onto the claims register / system...


  • Cape Town, Western Cape, South Africa Measured Ability Full time

    Job DescriptionWe are looking for a highly skilled Policy Claims Assessor to join our team at Measured Ability. In this role, you will be responsible for evaluating policy claims, ensuring compliance with regulations, and maintaining accurate records.About the Position:The successful candidate will have extensive knowledge of medical aid operations and...

  • Claims Assessor

    3 weeks ago


    Cape Town, South Africa Rand Mutual Assurance Full time

    **THE JOB AT A GLANCE** As a Claims Assessor, you will be reporting to the Team Leader: Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Claims Adjudication**: - Verify claims captured for...

  • Claims Assessor X2

    2 weeks ago


    Cape Town, South Africa Momentum Metropolitan Holdings Full time

    -Introduction Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by...


  • Cape Town, Western Cape, South Africa Measured Ability Full time

    Job SummaryWe are seeking a skilled Gap Insurance Validator to join our team at Measured Ability. The ideal candidate will possess a deep understanding of medical aid operations and insurance policy administration, with excellent analytical and communication skills.About the Role:In this role, you will be responsible for reviewing and validating gap...


  • Cape Town, South Africa Discovery Ltd. Full time

    **Business Unit**:Discovery Life **Function**:Claims Administration **Date**:5 Mar 2025 - Discovery - Discovery Life - Claims Assessor Specialist **About Discovery** - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose,...


  • Cape Town, Western Cape, South Africa Santam Insurance Full time

    If you're looking for a challenging and rewarding role that will allow you to grow and develop your skills, consider becoming an Insurance Merit Assessor at Santam.About the RoleThis role involves working closely with our customers to assess claims and provide fair and timely settlements. As an Insurance Merit Assessor, you will be responsible for evaluating...


  • Cape Town, Western Cape, South Africa Santam Insurance Full time

    About the RoleThis opportunity is available at Santam Direct Claims department for a Desktop Non-Motor Claims Assessor, to be based in Cape Town.Responsibilities include determining the quantum and merit of segmented non-motor claims by performing investigations, verifying the description of the event with the loss, negotiation (with client, and service...

  • Claims Assessor

    3 weeks ago


    Eastern Cape, South Africa Health Solutions Full time

    **Introduction** - Momentum Health, an entity of the Momentum Metropolitan Group, delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation and create value through unique insights of how to achieve specific outcomes by using a...


  • Cape Town, Western Cape, South Africa Status Staffing Full time

    Job DescriptionThis role involves working as part of a dynamic team to provide expert claims advice to clients. You will need to administer the complete claims process, from notification to settlement, and ensure that all relevant documentation is obtained and maintained.You will also be responsible for appointing assessors or loss adjustors, applying policy...

  • Claims Consultant

    4 weeks ago


    Cape Town, South Africa Yazoo Recruitment Specialists Full time

    Commercial Claims Consultant with minimum 3 years’ Commercial Claims experience in the Short Term Insurance Claims environment, specifically with a Broker with a binder facility, required to start asap. - Grade 12 - RE Certificate essential - Relevant FAIS accreditation required - Minimum 3 years relevant commercial claims experience essential - Experience...

  • Claims Consultant

    3 weeks ago


    Cape Town, South Africa Yazoo Recruitment Specialists Full time

    Short Term Insurance Claims Consultant with minimum 3 years’ commercial claims experience in an Insurer environment, required for a position with an FSP, based in Cape Town City Bowl. Minimum requirements: - Grade 12/Matric essential - FAIS compliant - relevant FAIS credits/NQF4 or NQF5 Short Term Insurance - RE5 essential - Minimum 3 years’ commercial...

  • Claims Consultant

    5 days ago


    Cape Town, Western Cape, South Africa RBS Full time

    Job title : Claims Consultant - PipelineJob Location : Western Cape, Cape TownDeadline : April 19, 2025Quick Recommended LinksJobs by Location Job by industries What You'll Do:Minimise claims expenses and general costs effectively. Deliver accurate, professional, and timely communication to all stakeholders, ensuring client satisfaction. Build lasting...


  • Cape Town, South Africa Yazoo Recruitment Specialists Full time

    Commercial Claims Consultant with minimum 3 years’ Commercial Claims experience in the Short Term Insurance Claims environment, specifically with a Broker with a binder facility, required to start asap. **Minimum requirements**: - Grade 12 - RE Certificate essential - Relevant FAIS accreditation required - Minimum 3 years relevant commercial claims...