Quality Assurance Specialist

3 days ago


Sandton, South Africa Guardrisk Group Full time
Job Title: Claims Quality Assessor (ADMED)

Role Description:

This role involves quality assessing all claims processed by the Admed claims team that is automatically allocated to your workflow in the OWLS system.

You will be responsible for:

  • Validating personal information, clinical information, documents attached, and decision made on the claim
  • Investigating all claims flagged by the OWLS system as possible pre-existing conditions within 2 working days

Requirements:

  • Matric / Grade 12 qualification
  • Basic medical qualification an advantage
  • MS Office computer skills
  • At least 3 years medical aid or gap cover claims processing and assessing experience
  • At least 2 years insurance experience

Benefits:

  • Dynamic work environment
  • Opportunities for career growth

Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Quality Assurance



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