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Claims Assessor
Momentum Metropolitan Holdings LimitedDurban, ZA23 days ago
Job descriptionAssess and process medical aid claims as per Claims procedures. Matric Computer literate. Comprehensive knowledge of all aspects of medical aid assessing is essential. Working on the Oracle platform is an advantage. A minimum of 2 - 3 years' experience as a claims assessor is an advantage. Industry knowledge (BHF; Tariff Guide; SAMA, ICD10 codes) is an advantage Accurately capture and process all incoming medical aid claims (paper, EDI, real time, workflow)with in agreed time frames. Able to assist cross functionally in the claims department. Processing of claims according to predetermined standards and business processes on the Oracle platform. Ensure that claims validation is performed in accordance with legislation and scheme rules. Quality control to ensure error rate is minimised. Work on KRIS reports / departmental reports. Pay claims correctly the first time and on time to members or service providers there by reducing repeat queries and escalations. Attention to detail and accuracy Problem solving ability Ability to function effectively within a team. Ability to work under pressure. Consistently works to meet expectations. Resolves client problems within his or her job scope. Is engaged and demonstrates energy in the execution of tasks. Accepts accountability for own mistakes and ensures corrective action is taken. Insurance jobs
Job title : Claims Assessor
Job Location : KwaZulu-Natal, Durban
Deadline : October 21, 2025
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Deadline : 14th October,2025
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Assessor • Durban, ZA
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