GAP Claims Assessor - - Claremont

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EMPLOYMENT TYPE : Permanent
SECTOR : Finance
BASIC SALARY : R16,000
START DATE : A.S.A.P / Immediate

REQUIREMENTS:

2 years experience in a similar role
Insurance industry experience (essential)
Medical Aid claims processing and administration experience (essential)
Ability to work well under pressure
Commitment to meet daily targets
Self-motivated
Having a can do attitude
Good written and verbal communication skills
Good negotiation skills
Good understanding of how medical aids work and operate
Intermediary MS Office, especially Excel, Word and Microsoft Outlook skills
Good time management skills
Works well in a team and independently
Copes well with pressure and setbacks
Pro-active and using your initiative

DUTIES:

Check and validate all GAP claim documents received and to request any outstanding documents
Follow the claims process and capture the claim information onto the system
Verify and update any client personal information changes on the system policy record
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
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
Meet your daily minimum claim targets with a high level of accuracy and within service turnaround time Maintain and update your daily workflow tasks and queue
Ensure high priority and escalated claims as identified by management are processed within 2 hours Interact with medical aids, hospitals and medical practitioners regarding medical history and accounts required relevant to assessing the claim

HOURS: