Gap Claims Specialist at Kaelo

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