Job Description:

Claims Assessor will be assisting the Claims Assessing Department

Key Responsibilities and

Duties:

The duties briefly listed below will be subject to amendment from time to time as required based on discussions with your manager
• To check and validate all GAP claim documents received and to request any outstanding documents
• To follow the claims process and capture the claim information onto the system
• To verify and update any client personal information changes on the system policy record
• 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
• To 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
• To meet your daily minimum claim targets with a high level of accuracy and within service turnaround time
• To maintain and update your daily workflow tasks and queue
• To ensure high priority and escalated claims as identified by management are processed within 2 hours
• Interacting with medical aids, hospitals and medical practitioners regarding medical history and accounts required relevant to assessing the claim.
• Other administration related functions

Skills:
• 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

Attitude:
• Ability to work well under pressure
• Commitment to meet daily targets
• Self-motivated
• Having a can-do attitude
• Willingness to always assist clients with their claims and requirements
• Actual Medical Aid claims processing and administration experience
• Insurance industry experience

To apply, please submit your CV, as well as your latest payslip, to AtripleA recruitment & temps
Claims Assessor position available in Western Cape, Cape Town. This job position was posted by AtripleA recruitment & temps. The job has been posted as a free ad on 2025-03-29 at 16:11:15 in the It Computer category

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Job Description &

Duties:

The duties briefly listed below will be subject to amendment from time to time as required based on discussions with your manager
• To check and validate all GAP claim documents received and to request any outstanding documents
• To follow the claims process and capture the claim information onto the system
• To verify and update any client personal information changes on the system policy record
• 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
• To 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
• To meet your daily minimum claim targets with a high level of accuracy and within service turnaround time
• To maintain and update your daily workflow tasks and queue
• To ensure high priority and escalated claims as identified by management are processed within 2 hours
• Interacting with medical aids, hospitals and medical practitioners regarding medical history and accounts required relevant to assessing the claim.
• Other administration related functions

Skills:
• 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

Attitude:
• Ability to work well under pressure
• Commitment to meet daily targets
• Self-motivated
• Having a can-do attitude
• Willingness to always assist clients with their claims and requirements
• Actual Medical Aid claims processing and administration experience
• Insurance industry experience

To apply, please submit your CV, as well as your latest payslip, to AtripleA recruitment & temps
Claims Assessor position available in Western Cape, Cape Town. This job position was posted by AtripleA recruitment & temps. The job has been posted as a char8000 ad on 2025-03-29 at 16:10:57 in the Finance Accounting category

Click Go Apply to apply online!

You might also like these jobs in the same area.

More related positions