Overview
Clinical Administrator (Zestlife) Jobs in Cape Town, Western Cape, South Africa at Momentum
Title: Clinical Administrator (Zestlife)
Company: Momentum
Location: Cape Town, Western Cape, South Africa
Closing Date 2025/03/26
Reference Number MMH250312-1
Job Title Clinical Administrator (Zestlife)
Position Type Permanent
Role Family Client Services
Cluster Guardrisk
Remote Opportunity Some of the time
Location – Country South Africa
Location – Province Western Cape
Location – Town / City Claremont, Cape Town
Introduction
We are seeking a highly skilled and experienced Clinical Administrator/ Clinical Specialist to join our team. The successful candidate will be responsible for handling claims clinical responsibilities for GAP Short Term Insurance Products, ensuring that the principles and outcomes of Treating Customers Fairly (TCF) are practiced and achieved.
Disclaimer As an applicant, please verify the legitimacy of this job advert on our company career page.
Role Purpose
Claims clinical responsibilities in respect of GAP Short Term Insurance Products.
Ensuring that the principles and outcomes of TCF (Treating Customers Fairly) are practised and achieved in all duties performed and services provided to Zest life customers.
Requirements
Matric/Grade 12 National Senior Certificate or equivalent
Relevant qualification in a medical or related field (e.g., nursing, medical technology)
Minimum 2-3 years of experience within the life insurance industry in a clinical or claims assessment/administration role
Strong knowledge of medical aid schemes
Understanding of anatomy and physiology
Proficient in Microsoft Office and claims management systems
Duties & Responsibilities
Handle claims clinical responsibilities for GAP Short Term Insurance Products
Ensure TCF principles and outcomes are practiced and achieved
Investigate PMB internal claims and negotiate discounts with service providers
Conduct pre-existing claim investigations and recommend outcomes
Resolve client queries and manage expectations
Maintain and update workflow queue records and own mailbox
Perform claim recovery follow-ups and issue acknowledgement of refunds received communications
Competencies
Results and solutions driven with a strong sense of responsibility and ownership
Excellent verbal and written communication and interpersonal skills
Fully bilingual – ability to speak English and Afrikaans fluently
Self-driven with an ability to work independently as well as to function effectively within a team
Strong attention to detail and organizational skills
Ability to prioritize tasks and manage multiple deadlines
Strong customer service orientation and skills with the ability to manage angry clients, client expectations and to communicate requirements clearly
Discipline, reliable and good time management skills
Strong administrative skills – with attention to detail and accurate
Quick to learn
Adaptability and use initiative
Resilience and ability to work under pressure
Willing to go beyond the normal working day to achieve target service levels
