Medical/GAP Claims Assessor
2 months ago
Medical/GAP Claims Assessor - Client Services (Inbound Contact Centre)
Southern Suburbs, Cape Town (Office based)
Salary Negotiable on experience (R12K - R18 K CTC PM)
My client, a leading established Long-term Insurance Corporate (Medical/Individual Life Insurance) are looking for an experienced Medical/GAP Claims Assessor.
Fast paced, cutting edge – customer centric environment – providing first line support to members re. Medical aid and Individual Life Insurance queries.
Criteria:
•Matric minimum + MS Office literate
•Must have 2 years medical aid/insurance experience (Inbound Contact Centre) with Medical Aid claims processing and administration experience.
•GAP Claims Assessing knowledge & experience (advantageous)
KPIs
As Medical/GAP Claims Assessor - Dealing with Medical Gap products and communicating with Medical Aid Schemes, Doctors & Hospitals.
•To assess, verify and update all personal contact information for clients including the Medical Aid details and latest claim.
•Interacting with medical aids/ medical practitioners regarding medical history and accounts required relevant to assessing the claim.
•Arranging for priority claim investigations and escalations.
•To assess the validity of the claim in accordance with the terms and conditions of the client’s policy document and to make the relevant claim notes on the system.
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