Medical/GAP Claims Assessor - Client Services

25 days ago315 views
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General Details
Location:
Other, Southern Suburbs
Advertised By:Agency
Company Name:Career Dynamics
Job Type:Full-Time
Employment Equity:Non EE/AA
Description

Medical/GAP Claims Assessor - Client Services & Client Services Administrator (I NBOUND Contact Centre)

Southern Suburbs, Cape Town (Office based)

Salary Negotiable on experience (R12K - R18 K CTC PM)


My client, a leading established Long-term Insurance Corporate (Medical/Individual Life Insurance) are looking for an experienced Medical/GAP Claims Assessor.

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 2 years medical aid/insurance experience (Inbound Contact Centre) with Medical Aid claims processing and administration experience.
  • GAP Claims Assessing knowledge & experience (advantageous)

KPIs

As Medical/GAP Claims Assessor - Dealing with Medical Gap products and communicating with Medical Aid Schemes, Doctors & Hospitals.

  • To assess, verify and update all personal contact information for clients including the Medical Aid details and latest claim.
  • Interacting with 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.
Client Contact Centre Service Inbound Administrator

Negotiable on experience (R12K - R15K CTC PM)

My client, a leading established Long-term Insurance Corporate (Medical/Individual Life Insurance) are looking for an experienced Client Contact Centre Service Inbound Administrator

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
  • 2 years Medical aid/Insurance experience / Medical Aid Client Services in an Inbound Contact Centre OR Medical Aid claims processing and administration

experience And/ Or Individual Life Policy Admin. Knowledge and

exp.

  • GAP Claims Assessing knowledge & experience (advantageous)
  • Excellent written and verbal communication skills, accompanied with good negotiation skills and effective in dealing with customers, meeting their expectations.

KPIs

As Client Contact Centre Service Consultant To be logged onto the Client

Services inbound telephone queue and web touchpoint

• Resolve a minimum of 30 telephone calls per day - To strive to have zero lost calls per day.

• Answering the telephone within 2 rings and resolving the client/broker query/request in a professional and timeous manner.

• To respond to and resolve about 15 general/claim related correspondence queries per day within a 24-hour turnaround time.

Please email your CV to natalie@careerdynamics.co.za


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Natalie Erasmus
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