motivate a team of claims professionals handling short-term and life insurance claims.
-Provide ongoing
objectives.
Claims management:
-Oversee the end-to-end claims process for both short-term
short-term and life insurance claims, ensuring adherence to company policies, procedures, and regulatory
escalated claims, providing guidance and assistance to team members as needed.
-Monitor claims metrics
Excellence:
-Champion a client-centric approach to claims management, prioritising prompt and empathetic
>Title: Team Leader – Short Term and Life Claims
Location: Pretoria East
Reports to: Claims Manager
Job Term and Life Claims Team Leader is responsible for leading and managing a team of claims professionals short-term and life insurance claims. The role involves overseeing the end-to-end claims process, ensuring timely timely and accurate claims adjudication, providing guidance and support to team members, and fostering
experience in processing claims . 1 Year experience in forensic/investigative claims assessing or dealing dealing with fraud, waste and abuse claims in a medical scheme .
Requirements:
claims assessing and the understanding thereof. An understanding of claims processing system within 3 months). Understanding and knowledge of Medical Scheme Rules/compliancy. Proven working experience investigate/identify fraud, waste and abuse claims and submission of claim reports with updates on traction. Detect
Client:
Our client is a leading medical scheme based in Pretoria, dedicated to providing
support on various BIT platform modules, including claims, finance, membership, and manage healthcare.
• Exposure within the Medical Aid environment is advantageous.
• Analytical
disability benefits, funeral cover, pension fund, medical aid, and more.
• Office perks: free parking
members. Apply today to contribute to a leading medical scheme's success and make a difference in the
regarding patient appointments. Contact various Medical Aids regarding coverage and payment plans. Perform invoices to Medical Aid companies and patients. Receive and process payments made by patients or Medical Aids efficiently and accurately gathering all personal and medical aid details. Manage all social media platforms and
regarding patient appointments. Contact various Medical Aids regarding coverage and payment plans. Perform invoices to Medical Aid companies and patients. Receive and process payments made by patients or Medical Aids efficiently and accurately gathering all personal and medical aid details. Manage all social media platforms and
authorization. Be able to assist the medical scheme with paper claim pricing for member reimbursement.
Qualifications:< isiXhosa, isiZulu.
with minimum contribution of 6 % Medical aid: Must be on medical aid – proof of membership will be required
with minimum contribution of 6 % Medical aid: Must be on medical aid – proof of membership will be required
professional mannerisms Computer literacy R8 000.00 CTC medical aid and pension