Health Claims Specialist - Johannesburg, South Africa - Kaelo

Kaelo

Verified Company

Johannesburg, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Company Description

About 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.

Job Description:

Health Claims Specialist
The Kaelo Health 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 (not limited to) Level 4 and 5 process elements

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 Xelus members, brokers and franchises

Ongoing feedback to clients

Ad hoc functions as required by Management

Qualifications:

SPECIAL REQUIREMENTS
Communication skills

Analytical ability

Timer management

Team work

Customer focus

Ability to adapt to an ever changing environment

Cope well under pressure

PERSON DETAILS:
WORK EXPERIENCE

REQUIRED
Insurance industry experience

PREFERRED
Health Insurance industry

EDUCATION:

QUALIFICATIONS:
ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED
Grade 1- Matric

RE 5

Accreditation would be advantageous (a minimum of 120 credits)

PREFERRED
Accreditation would be advantageous (a minimum of 120 credits)

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED
Computer literate, including Microsoft Access

PREFERRED
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