Claims Assessor Position
4 weeks ago
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 ensure that all claims are assessed accurately and paid correctly in accordance with the clients benefit and tariff structures.
Key Responsibilities- Assess all claims using the appropriate rules and guidelines.
- Ensure accurate and timely processing of claims.
- Verify claim details and documentation for accuracy and completeness.
- Liaise with healthcare providers and members to resolve any claim-related queries or issues.
- Adhere to the client's benefit and tariff structures while processing claims.
- Maintain accurate records of all claims assessments and payments.
- Provide excellent customer service to members and healthcare providers.
- Assist with other administrative tasks as required.
- Grade 12 qualification.
- Minimum of 2 years' experience in claims assessing within the Medical Aid industry.
- Strong computer literacy, including proficiency in Microsoft Office applications.
- Excellent administration skills with a keen eye for detail.
- Good customer service skills with the ability to listen and communicate effectively.
- Ability to work efficiently in a fast-paced environment.
- Strong analytical and problem-solving skills.
- Competitive salary commensurate with experience.
- Exceptional benefits program including 23 days of annual leave, 8-hour workday with a 30min break, life cover, disability benefits, funeral cover, pension fund, medical aid, and more.
- Office perks: free parking, Wi-Fi, landline phone allowance, on-site gym, subsidized meals, free refreshments, Athletics Club, Pilates, and wellness programs.
- Dynamic team interactions, recognition programs, and incentives.
Be part of a team that values innovation, quality service, and the well-being of its members. Apply today to contribute to a leading medical scheme's success and make a difference in the lives of many.
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