Job Title Claims Team Member Position

7 days ago


Port Elizabeth, Eastern Cape, South Africa Momentum Full time
About the Role

We are looking for a skilled Claims Assessor to join our Claims Team at Momentum. The successful candidate will be responsible for ensuring accurate insertion and assessment of claims, as well as providing exceptional customer service.

Key Responsibilities:

  • Insert and assess claims accurately according to protocol.
  • Action claims-related adjustments based on journal instructions.
  • Provide professional assistance to clients and stakeholders.
  • Identify and escalate claims-related queries requiring additional investigation.
  • Conduct regular reporting and analysis of claims data.
  • Perform necessary corrections to claims following investigation.

Requirements:

  • National Senior Certificate (Bachelor's pass with Mathematics or Mathematical Literacy as a Grade 12 subject highly advantageous).
  • A business-related degree or diploma is preferred.
  • Minimum 1 year's experience in an administrative role required.
  • Prior experience in a medical scheme administrative environment is preferred.
  • Familiarity with medical claims processing and ICD-10 coding is highly advantageous.
  • Proficiency in the Microsoft Office Suite is essential.

What We Offer:

  • A competitive salary and benefits package.
  • Ongoing training and development opportunities.
  • A dynamic and supportive work environment.

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