Overview

Claims Assessor Jobs in Cape Town, South Africa at AtripleA Recruitment & Temps

Job Title:

Claims Assessor (Cape Town)

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

Title: Claims Assessor

Company: AtripleA Recruitment & Temps

Location: Cape Town, South Africa

Category:

 

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