Claims Assessor

2 weeks 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 upholding the highest standards in the industry is looking for a claims assessor to join their team.
As a Claims Assessor, you will play a crucial role in ensuring the efficient and accurate processing of insurance claims as well as the validity of the claims. Additionally, you will be responsible for communicating effectively with clients and brokers to address claim expectations and manage inquiries.
**Minimum Requirements**:
Medical Aid claims processing experience
Administration experience
Insurance industry experience
Excel proficient
MS Office proficient
**Duties**:
Review and authenticate all incoming GAP claim documents, and proactively request any missing documentation.
Adhere to established procedures for processing claims, meticulously recording all pertinent information into our system.
Validate and amend client personal data changes within the policy records on the system.
Evaluate claim legitimacy according to the terms and conditions outlined in the client's policy documentation, and meticulously document findings.
Ensure client satisfaction by effectively addressing and managing claim expectations, employing Treating Customers Fairly (TCF) principles, and maintaining clear communication with clients or brokers.
Achieve daily minimum claim targets with precision and within specified service timeframes.
Organize and update daily workflow tasks and queues to ensure timely processing.
Prioritize and expedite high-priority and escalated claims, ensuring resolution within a strict two-hour timeframe as directed by management.
Collaborate with medical aids, hospitals, and medical practitioners to gather relevant medical history and account details crucial for claim assessment.
Perform various administrative duties as needed to support departmental operations.
IMPORTANT: We specialize in specific niche fields. Regret that we are unable to provide assistance for any fields outside of this scope. Fields can be viewed on our website.
Kontak Recruitment Disclaimer:
Equal opportunity: All backgrounds are welcomed, with no bias. All are considered based on requirements.
Job specifics: Requirements mirror advertisement, duties may adjust for client needs.

Privacy: Data processed as per Privacy Policy. By applying, you agree to data handling. We safeguard applicant info.

Offer clarity: Advert is not a binding offer. Written offers based on pre-employment conditions.
No direct link: Advert is not tied to Kontak Recruitment. We assist in the employment process ONLY.
Applicant Responsibility: Upon applying, confirmation of receipt for a specific advert is given. If no confirmation is received, you must verify with Kontak Recruitment.


  • Claims Assessor

    5 days 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...

  • Gap Claims assessor

    Found in: Adzuna ZA B C2 - 2 weeks ago


    Cape Town, South Africa Adzuna ZA B C2 Full time

    Requirements: 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...

  • GAP Claims Assessor

    Found in: Talent ZA C2 - 3 weeks ago


    Cape Town, South Africa Status Staffing Full time

    Our Client in Claremont is looking to employ a GAP Claims Assessor with Medical Aid claims processing and administration / insurance industry experience to join their teamA recent professional profile photo is to accompany your applicationEMPLOYMENT TYPE   :           PermanentSECTOR                         :          ...

  • Senior Claims Assessor

    Found in: Talent ZA C2 - 5 days ago


    Cape Town, South Africa Old Mutual Full time

    Description & Key Result Areas: Coaching Provide guidance and mentorship to junior claims assessors Personal Effectiveness Accountable for managing own time effectively to meet service delivery needs Prioritise tasks and ensure high-quality output Makes increased contributions by broadening individual skills Collaborates effectively with...


  • Cape Town, South Africa PSG Insure Full time

    **Job description**: The Claims Administrator is responsible for coordinating and overseeing, managing, negotiating settlement of the claim and is accountable for the finalisation of the claim end-to-end. **Responsibilities**: - Register claims and appoint assessors - Manage claims in terms of claims SLA - Make decision regarding merit - indemnify or not -...

  • Claims Assessor

    Found in: Talent ZA C2 - 5 days ago


    Cape Town, South Africa Old Mutual Full time

    Description This role uses specialist technical knowledge to assess risk for the business and/or specific products.  This role is for a dynamic individual with a willingness to learn and be part of a specialised claims assessing team. Uses specialist technical knowledge to evaluate and manage the validity of contracts and determine and manage the...

  • GAP Claims Assessor

    Found in: Talent ZA 2A C2 - 3 weeks ago


    Cape Town, South Africa Status Staffing Full time

    A recent professional profile photo is to accompany your applicationEMPLOYMENT TYPE : PermanentSECTOR : FinanceBASIC SALARY : R16,000START DATE : A.S.A.P / ImmediateREQUIREMENTS:2 years experience in a similar roleInsurance industry experience (essential)Medical Aid...

  • Claims Assessor: Non Motor

    Found in: Talent ZA C2 - 3 weeks ago


    Cape Town, South Africa Old Mutual Full time

    Description Old Mutual Insure is looking for a forward-thinking , driven Claim Assessors in Cape Town and George . The role will effectively investigate, adjust and report on assigned claims, thus ensuring containment of all Non Motor claims spend on providing excellent service in setting a culture of best practice within mandated responsibility You...

  • Claims Specialist

    23 hours ago


    Cape Town, South Africa Sanlam Full time

    **Opportunity** - This career opportunity is available at **Echelon** a division of Santam for a **Claims Specialist - Recovery and Complex Claims Manager**, who will be based in **Cape Town.** **What will make you successful in this role?** - To be able to work well under pressure with mínimal supervision. - Be a disciplined individual with good attention...

  • Senior Underwriter

    Found in: Talent ZA C2 - 1 week ago


    Cape Town, South Africa Old Mutual Full time

    Description Role Overview Use your specialist technical medical knowledge to assess risk for business and/or specific products. Uses specialist technical knowledge to evaluate and manage the validity of contracts and determine and manage the liability of claims (Assessor). Determines, selects and accepts risk and/or liability on behalf of the...


  • Cape Town, South Africa O'Brien Recruitment Full time

    **Role Duties and Responsibilities**: - Manage the end to end claims process from lodgment to settlement. - Day to day management of claim lodgments, customer inquiries and validating reported insurance claims. - Answer incoming calls and provide customers with empathy, certainty, guidance and support from lodgment to final resolution of claim situations...


  • Cape Town, South Africa Job Crystal Full time

    **SPECIFICATION** A global InsureTech business is looking for a Claims and Customer Care to join their AU and NZ Team, but the position will be SA based (Working hours are 00h30 to 09h30) The business provides an end-to-end service where they facilitate the whole process from contacting the client to gathering information/evidence, reviewing and validating...

  • Quality Assessor

    5 days ago


    Cape Town, South Africa Health Solutions Full time

    **Introduction**Role Purpose** - This role offers exciting and challenging opportunities and is aimed at a dynamic, performance-orientated, knowledgeable, and experienced individual who can deliver quality outputs in a high deadline and client-orientated environment. You will be required to work well within a team as well as on your own. An exciting...

  • Claims Specialist

    Found in: Talent ZA C2 - 2 days ago


    Cape Town, South Africa Santam Full time

    Opportunity This career opportunity is available at Echelon a division of Santam for a Claims Specialist – Recovery and Complex Claims Manager , who will be based in Cape Town.  What will make you successful in this role? To be able to work well under pressure with minimal supervision. Be a disciplined individual with good attention...


  • Cape Town, South Africa Surgo HR & Training Full time

    Calling all Cycling enthusiasts, w ith a passion for sales! Do you enjoy the outdoors? Are you an active person? Is Cycling your passion? **Purpose**: We are cyclists in the insurance industry. Our specialty is getting our fellow cyclists back in the saddle after an unfortunate event happens. We have thirteen years of experience when it comes to...


  • Cape Town, South Africa Telesure Investment Holdings Full time

    JOB PURPOSE Support the claims handling philosophy and supply strategy by mitigating risk of vehicle spend (quantification, identification and validation of vehicle). All services are delivered against agreed service and functional standard. RESPONSIBILITIES Operations Management Carry out operational tasks by following established processes. This will...

  • Inbound Client Contact Centre Administrator

    Found in: Adzuna ZA B C2 - 2 weeks ago


    Cape Town, South Africa Adzuna ZA B C2 Full time

    The contact centre is responsible for the inbound telephonic servicing of the individual policyholder and brokers with the aim of providing a first call resolution experience, while maintaining a high standard of customer service. They also respond to claim-related queries and correspondence received.Requirements: Must have a thorough understanding of...