Gap Claims Assessor

A recent professional profile photo is to accompany your application 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: 08:00 17:00 Monday - Friday