Health Claims Administrator

Johannesburg, Gauteng, South Africa

Job Description


Company DescriptionAbout Kaelo
Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.The Kaelo Health Claims Administrator is responsible for the management of all gap cover related tickets and correspondence. The responsible person captures all gap cover claims and corresponds with the membership base. This individual has knowledge of the gap claims environment. There is a strong focus on accurately and efficiently resolving the claim ticket received whilst ensuring effective communication and exceptional customer service and satisfaction.KEY OUTCOMES(not limited to) Level 4 and 5 process elementsThe accurate and efficient capturing of claims receivedAssist Kaelo clients with queries and provide suitable query resolutionAccurate completion of administrative targets on a daily basisDealing with multiple queries from Kaelo members and intermediariesOngoing feedback to clientsManagement of all claim related mailboxesAd hoc functions as required by managementSPECIAL REQUIREMENTSGood communication skillsAnalytical abilityTime managementTeam workCustomer focusData capturing experienceQualificationsPERSON DETAILS: WORK EXPERIENCEREQUIREDInsurance industry experience2-5 Years experience in claims handlingPREFERREDHealth Insurance industryEDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODYREQUIREDFAISREQUIREDGrade 12 MatricPREFERREDRE5 certificateTECHNICAL SKILLS OR KNOWLEDGEREQUIREDComputer literate, including Microsoft Access and Intermediate Excel Skills.PREFERREDExperience on MIP systemAdditional Information

  • Accountability
  • Action orientated
  • Collaborative
  • Communication
  • Business writing skills
  • Manage complexity
  • Problem solving skills
  • Decision thinking
  • Encourages engagement
  • Resilient and adaptive
  • Resourceful
  • Demonstrates self-awareness
  • Purpose driven
  • Significance and values orientated

Kaelo

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Job Detail

  • Job Id
    JD1395608
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    Johannesburg, Gauteng, South Africa
  • Education
    Not mentioned