Gap Claims Specialist at Kaelo Engage

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

Personal Attributes 

• Accountability

• Action Orientated

• Collaborative 

• Communication Skills 

• Simple Writing Skills 

• Manages Complexity

• Problem Solving Skills 

• Creative Thinking

• Decision Making SKills 

• Efficient and Effective Mindset

• Financial Acumen

• Planning and Organisation 

• Resilient and adaptive 

• Resourcesful

• Signancance and values orientated