Gap Claims Assessor

START DATE : A.S.A.P / ImmediateREQUIREMENTS:2 years' experience in a similar roleInsurance industry experience (essential)Medical Aid claims processing and administration experience (essential)Ability to work well under pressureCommitment to meet daily targetsSelf-motivatedHaving a can do attitudeGood written and verbal communication skillsGood negotiation skillsGood understanding of how medical aids work and operateIntermediary MS Office, especially Excel, Word and Microsoft Outlook skillsGood time management skillsWorks well in a team and independentlyCopes well with pressure and setbacksPro-active and using your initiative DUTIES: Check and validate all GAP claim documents received and to request any outstanding documentsFollow the claims process and capture the claim information onto the systemVerify and update any client personal information changes on the system policy recordAssess 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 systemEnsure a client's claim expectation is adequately addressed and managed by applying the TCF principals and effectively communicating with the client or broker regarding their claimMeet your daily minimum claim targets with a high level of accuracy and within service turnaround time Maintain and update your daily workflow tasks and queueEnsure 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: 08:00 – 17:00 Monday - Friday