Claims Specialist

7 days ago

Centurion, South Africa Health Solutions Full time

**Introduction**
- Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.**Role Purpose**
- To provide an effective and efficient service to clients by receiving, evaluating and responding to telephonic/electronic enquiries timeously. Provide feedback to claims queries, investigations, escalated complaints, and client service queries.**Requirements**:

- Grade 12 with at least 50% achieved for Mathematics or 60% Mathematical Literacy.
- 2- 4 years claims assessing related experience within a medical aid administration environment.
- Computer Literacy (i.e. E-mail, Word and Excel).
- Thorough knowledge of the MH claims operating system.
- Experience in electronic and paper claims assessing.

**Duties & Responsibilities**
- Assessing both EDI and paper claims.
- Liaising with external business partners.
- Providing quality written feedback to claims queries.
- E-mail investigations, escalated complaints, and Client service queries.
- Ensure all correspondence is archived and dealt with timeously.
- Provider/member investigation.
- Provider/membership profiling and trend analysis.
- In-depth understanding of various claims processing methods.

**Competencies**
- Analysis
- Problem Solving
- Attention to detail
- Effective Communication Skills (verbal and written)
- Ability to work in a fast pace and pressurised environment
- Results orientated

  • Senior Death Benefit Claims Specialist

    2 weeks ago

    Centurion, South Africa Momentum Full time

    A leading financial services company in Centurion seeks a specialist for death benefit claims assessment. The role involves developing claims methodology, ensuring compliance with regulations, and enhancing client experience through effective assessment and reporting. Candidates should have a relevant business qualification and experience in life insurance...

  • Service Specialist

    7 days ago

    Centurion, South Africa Momentum Investments Full time

    **Introduction** **Role Purpose** The Service Specialist (Death Claims) will oversee the complete servicing of death claims (deceased estates) within the RISO business unit. This includes timely handling and support for claims received from various investment platform clients. Responsibilities encompass reviewing received death claims, soliciting missing...

  • Claims Consultant

    1 week ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** Our consultants...

  • Service Specialist: Death Claims

    5 days ago

    Centurion, Gauteng, South Africa Momentum Full time R250 000 - R500 000 per year

    Through our client-facing brands and our other specialist brands, Momentum Group enables business and people from all walks of life to achieve their financial goals and life aspirations.We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and...

  • Claims Assessor

    5 days ago

    Centurion, Gauteng, South Africa MOMENTUM LIFE Full time R250 000 - R450 000 per year

    IntroductionThrough our client-facing brands Metropolitan and Momentum, with Momentum Multiply (our wellness and lifestyle rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow...

  • Personal Lines Claims Handler

    3 days ago

    Centurion, South Africa The Talent Hive Full time

    Capturing of all new claim where applicable. - One point of contact for the client/broker and adherence to first call resolution. - Deliver exceptional client service that exceeds customers’ expectations through proactive, innovative and appropriate claims handling. - Ensures that customer claim is handled efficiently. - Verifies FNOL data or documentation...

  • Death Claims Assessor

    1 week ago

    Centurion, Gauteng, South Africa Momentum Group Limited Full time R300 000 - R600 000 per year

    IntroductionThrough our client-facing brands Metropolitan and Momentum, with Momentum Multiply (our wellness and lifestyle rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations.We help people grow...

  • Claims Investigator: Multi-skilled

    1 week ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** To contribute to the...

  • Claims Investigator: Personal Lines

    1 week ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** To contribute to the...

  • Claims Investigator: Personal Lines

    1 week ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** To contribute to the...