Medical/GAP Claims Assessor x 3
CPT/Southern Suburbs (Office based during probation period)
Salary Negotiable on experience (R12K - R19 K CTC PM)
My client, a leading established Long-term Corporate (Medical Aid/Health Insurance) are looking for an experienced A Medical/GAP Claims Assessor. Experienced as a Broker in the Medical Aid/Health Industry.
Fast paced, cutting edge – customer centric environment – providing first line support to members re. Medical aid and Individual Life Insurance queries.
Criteria:
•Matric minimum + MS Office literate
•Must have Brokerage experience within the Medical Aid industry.
•Candidate must be able to speak, read and write English and Afrikaans (Excellent written and verbal communication skills)
•2 years exp. As a Broker in Medical Aid claims processing and administration Broker experience - Inbound Contact Centre.
•GAP Claims Assessing knowledge & experience (advantageous)
•Good negotiation skills and effective in dealing with customers, meeting their expectations.
KPIs
As Medical/GAP Claims Assessor
•To assess, verify and update all personal contact information for clients including the Medical Aid details and latest claim.
•Interacting with brokers/medical aids/medical practitioners regarding medical history and accounts required relevant to assessing the claim. Arranging for priority claim investigations and escalations.
•To assess the validity of the claim in accordance with the terms and conditions of the client’s policy document and to make the relevant claim notes on the system.