Job Description
About the Role
We are seeking a skilled Claims Assessor to join our team in Cape Town. As a Claims Assessor, you will be assisting the Claims Assessing Department and playing a crucial role in evaluating claims and ensuring that clients’ expectations are adequately addressed. If you have excellent communication skills, attention to detail, and experience in medical aid claims processing, we want to hear from you.
Key Responsibilities
- Check and validate all GAP claim documents received and request any outstanding documents
- Follow the claims process and capture the claim information onto the system
- Verify and update any client personal information changes on the system policy record
- Assess the validity of the claim in accordance with the terms and conditions of the client’s policy document and make relevant claim notes on the system
- Ensure a clients claim expectation is adequately addressed and managed by applying the TCF principals and effectively communicating with the client or broker regarding their claim
- Meet your daily minimum claim targets with a high level of accuracy and within service turnaround time
- Maintain and update your daily workflow tasks and queue
- Ensure high priority and escalated claims as identified by management are processed within 2 hours
- Interact with medical aids, hospitals, and medical practitioners regarding medical history and accounts required relevant to assessing the claim
- Other administration related functions
Requirements
- Good written and verbal communication skills
- Good negotiation skills and effective in dealing with customers and meeting their expectations
- Good understanding of how medical aids work and operate
- Ability to apply administration principals and work with detail and a high level of accuracy
- Intermediary MS Office, especially Excel, Word, and Microsoft Outlook skills
- Good time management
- Planning and organising
- Works well in a team and independently
- Coping with pressure and setbacks
- Been pro-active and using your initiative
Qualifications
- Matric (or equivalent)
- No formal education qualifications required
How to Apply
Click the green “Go Apply” button below to apply directly online with the employer.
About Other IT/Computer Jobs in Western Cape
The Western Cape, situated on the south coast of South Africa, is home to a thriving IT industry that offers a diverse range of career opportunities for professionals with expertise in various fields.
The job market in the Western Cape is highly competitive, with many major companies and startups operating in the region. The province’s strategic location, combined with its well-developed infrastructure, makes it an attractive hub for businesses looking to establish themselves in Africa. As a result, there is a high demand for skilled IT professionals who can support the growth of these companies.
The average salary ranges for IT professionals in the Western Cape are as follows: software engineers and developers can expect to earn between R800 000 to R1 200 000 per annum; data scientists and analysts can range from R600 000 to R900 000; cybersecurity specialists can earn anywhere from R500 000 to R800 000; and IT project managers can command salaries ranging from R400 000 to R700 000. These figures are based on industry standards and may vary depending on factors such as experience, qualifications, and company size.
To succeed in an IT career in the Western Cape, professionals need to possess a range of key skills, including programming languages (Java, Python, C++), data structures and algorithms, software development methodologies, cloud computing (AWS, Azure, Google Cloud), cybersecurity principles, and excellent communication skills. Additionally, knowledge of industry-specific tools and technologies, such as SAP or Oracle, can be highly valued.
Several major companies and industries are actively hiring IT professionals in the Western Cape. For example, tech giants like IBM and Dell have a strong presence in the region, while financial institutions such as Standard Bank and First National Bank also have significant IT departments. The automotive industry is another major sector that employs IT professionals, with companies like Toyota and Volkswagen having operations in the province.
Career growth opportunities are plentiful for IT professionals in the Western Cape, with many companies offering training and development programs to help employees upskill and reskill. With experience, professionals can move into senior roles such as technical lead or manager, or transition into related fields like business analysis or consulting. The region’s entrepreneurial spirit also makes it an ideal location for startups, providing opportunities for IT professionals to launch their own businesses or join innovative companies that are shaping the future of technology.
This information provides general career guidance. Actual salaries and requirements vary by employer.
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