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Gap Claims Specialist

KaeloZA

11 days ago

Job description

Job title : Gap Claims Specialist

Job Location : KwaZulu-Natal,

Deadline : October 17, 2025

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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

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