Health Claims Administrator

Company DescriptionAbout KaeloKaelo 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.Job DescriptionThe 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)The 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 mailboxesSPECIAL REQUIREMENTSAd hoc functions as required by managementGood communication skillsAnalytical abilityTime managementTeam workCustomer focusData capturing experienceQualificationsWORK EXPERIENCE REQUIREDInsurance industry experience2-5 Years experience in claims handlingPREFERREDHealth Insurance industry experienceEDUCATION : QUALIFICATIONS : ACCREDITATIONS WITH PROFESSIONAL BODY REQUIREDFAISGrade 12 – MatricPREFERREDRE5 certificateTECHNICAL SKILLS OR KNOWLEDGEComputer literate, including Microsoft Access and Intermediate Excel Skills.PREFERREDExperience on MIP systemAdditional InformationAccountabilityAction orientatedCollaborativeCommunicationBusiness writing skillsManage complexityProblem solving skillsDecision thinkingEncourages engagementResilient and adaptiveResourcefulDemonstrates self-awarenessPurpose drivenSignificance and values orientated

J Ljbffr