Claims Assessor

4 weeks ago


Cape Town, Western Cape, South Africa Status Staffing Full time
Job Title: GAP Claims Assessor

We are seeking a highly skilled GAP Claims Assessor to join our team at Status Staffing. As a key member of our team, you will be responsible for assessing and validating GAP claims, ensuring that our clients receive accurate and timely resolutions.

Key Responsibilities:
  • Validate and assess GAP claim documents, ensuring accuracy and completeness
  • Follow the claims process, capturing claim information onto our system
  • Verify and update client personal information changes on our system policy record
  • Assess claim validity in accordance with policy terms and conditions, making relevant claim notes on our system
  • Ensure client claim expectations are met, applying TCF principles and communicating effectively with clients or brokers
  • Meet daily minimum claim targets with high accuracy and within service turnaround time
  • Process high-priority and escalated claims within 2 hours, interacting with medical aids, hospitals, and medical practitioners as needed
Requirements:
  • 2 years' experience in a similar role
  • Insurance industry experience (essential)
  • Medical Aid claims processing and administration experience (essential)
  • Ability to work well under pressure
  • Commitment to meet daily targets
  • Self-motivated
  • Good written and verbal communication skills
  • Good negotiation skills
  • Good understanding of how medical aids work and operate
  • Intermediate MS Office skills, especially Excel, Word, and Microsoft Outlook
  • Good time management skills
  • Works well in a team and independently
  • Copes well with pressure and setbacks
  • Pro-active and uses initiative
Working Hours:
  • 08:00 – 17:00, Monday to Friday

If you meet the requirements, please apply on our website at www.statusstaffing.com today. We will retain your credentials for future similar roles.


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