Claims Assessor - Claremont
A vacancy exists for a Claims Assessor in our Gap Claims Assessing Department. (Claremont Cape Town) Job description & duties: The duties for which you will be responsible in terms of this contract are briefly listed below and 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 clients 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
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