Claims Administrator
SD Recruitment (Pty) Ltd
Bryanston, South Africa, Gauteng, ZA
4d ago

Medical Financial Services Company in Bryanston requires a Claims Administrator (Gap Cover)

  • Matric
  • FAIS Compliant (Qualification, RE 5 and class of business a must)
  • Customer Service Certificate
  • Skills and Experience : -

  • At least 2 years’ gap cover or medical claims experience
  • Technical knowledge on various health insurance products
  • Knowledge of ICD Codes, medical procedures and medical aid schemes
  • Understanding of PMB legislation in conjunction with Gap Cover
  • Sound computer skills - Microsoft Office a must
  • Excellent customer service skills
  • Takes ownership and responsibility
  • Ability to work in a team with minimal supervision
  • Pays attention to detail
  • Excellent analytical skills
  • Ability to handle pressure - always remain calm, friendly,
  • courteous, polite, professional and willing to assist

  • Assess claims
  • Request outstanding information from clients (telephonic & e-mail)
  • Ensure that claims are processed according to the rules, benefits and conditions of the policy
  • Contact service providers for discounts when claims are over the company prescribed threshold
  • Ensure that all policy limitations, waiting periods, exclusions are appropriate and in line with the policy
  • Attend to customer queries
  • Any other duties as requested by the company from time to time
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