Health Claims Administrator

3 days ago


Johannesburg, South Africa Kaelo Full time
Job Description

The Kaelo Health Claims Administrator is responsible for the management of all gap cover related tickets and correspondence.  The responsible person captures all gap cover claims and corresponds with the membership base. This individual has knowledge of the gap claims environment. There is a strong focus on accurately and efficiently resolving the claim ticket received whilst ensuring effective communication and exceptional customer service and satisfaction.

 

KEY OUTCOMES

(not limited to) Level 4 and 5 process elements

The accurate and efficient capturing of claims received

Assist Kaelo clients with queries and provide suitable query resolution

Accurate completion of administrative targets on a daily basis

Dealing with multiple queries from Kaelo members and intermediaries

Ongoing feedback to clients

Management of all claim related mailboxes

Ad hoc functions as required by management

 

SPECIAL REQUIREMENTS

Good communication skills

Analytical ability

Time management

Team work

Customer focus

Data capturing experience


Qualifications

PERSON DETAILS: WORK EXPERIENCE

REQUIRED

Insurance industry experience

2-5 Years experience in claims handling

PREFERRED

Health Insurance industry

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

FAIS

REQUIRED

Grade 12 – Matric

PREFERRED

RE5 certificate

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

Computer literate, including Microsoft Access and Intermediate Excel Skills.

PREFERRED

Experience on MIP system



Additional Information

 

  •       Accountability
  •       Action orientated
  •       Collaborative
  •       Communication
  •       Business writing skills
  •       Manage complexity
  •       Problem solving skills
  •       Decision thinking
  •       Encourages engagement
  •       Resilient and adaptive
  •       Resourceful
  •       Demonstrates self-awareness
  •       Purpose driven
  •       Significance and values orientated

 

 



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