Website Kaelo
Kaelo provides innovative, essential, healthcare solutions enabling the physical and psychological well-being of all South Africans. Our one goal is to provide more South Africans with access to quality healthcare. We are progressive in our design, simple in our approach and sincere in the way we… read more engage, changing the way healthcare is delivered to meet the needs of our people.
Job Description
The Claims Specialist manages the assessment of claims and has specialised knowledge of the claims environment. There is a strong focus on accurately and efficiently resolving the claim received whilst ensuring exceptional customer service and satisfaction
Key Outcomes
The accurate and efficient processing of claims captured
Ad hoc duties- support in the operation of other divisions
Contribute towards continuous improvement and innovation at process and procedure level
To ensure that all claims processing and queries are attended to accurately and within the agreed turnaround time
Contribute toward risk management
Assist clients with queries and provide suitable query resolution
Accurate completion of administrative targets on a daily basis
Dealing with multiple telephonic queries from members, brokers and franchises
Ongoing feedback to clients
Ad hoc functions as required by Management
Qualifications
Work Experience
Required
Insurance Industry Experience
Preferred
Health Insurance Industry Experience
Education, Qualifications and Accreditation with Professional Body
Required
Matric
FAIS / RE5
Preferred
FAIS / RE5 Accreditation with minimum 120 credits
Technical Skills or Knowledge
Required
Computer Literate incl. Microsoft Access
Additional 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
Apply via company website ( N / A ) or
jobs.smartrecruiters.com