Vacancies at Kaelo

Company Description

Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change.

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 

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Job Description

• Recruitment of new affiliates on a monthly basis
• Managing the relationships with existing affiliates and building professional bonds with professionals

Qualifications

PERSON DETAILS : WORK EXPERIENCE

REQUIRED

• Minimum of 2 years administration experience

PREFERRED

• Experience in the EAP field or knowledge of the field is preferable

EDUCATION : QUALIFICATIONS : ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

• Administration

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

• Proficient in relevant computer applications
• Required language proficiency
• Knowledge of customer service principles and practices
• Knowledge of call centre telephony and technology
• Good data entry and typing skills
• Knowledge of administration skills and processes

PREFERRED

Additional Information

PERSONAL ATTRIBUTES : COMPETENCIES 

• Accountability
• Communication
• Business writing skills
• Efficient and effective mindset
• Planning and organisation
• Resilient and adaptive
• Self-development
• Significance and values oriented
• Ethical