Health Claims Administrator
Kaelo
Randburg, Gauteng
Administrative and clerical roles handle the day-to-day paperwork, scheduling and record-keeping that keep SA businesses running, and are a popular path for matriculants with strong organisation skills.
This listing does not state a salary. As a guide, admin roles in South Africa typically pay R8 000 to R20 000 a month (indicative).
Job 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
The Kaelo Health Claims Administrator is responsible for the management of all gap cover related tickets and correspondence. The responsible person captures all gap cover claims and corresponds with the membership base. This individual has knowledge of the gap claims environment. There is a strong focus on accurately and efficiently resolving the claim ticket received whilst ensuring effective communication and exceptional customer service and satisfaction
KEY OUTCOMES
(not limited to) Level 4 and 5 process elements
The accurate and efficient capturing of claims received
Assist Kaelo clients with queries and provide suitable query resolution
Accurate completion of administrative targets on a daily basis
Dealing with multiple queries from Kaelo members and intermediaries
Ongoing feedback to clients
Management of all claim related mailboxes
Ad hoc functions as required by management
Qualifications
Insurance industry experience
2-5 Years experience in claims handling
5 Years experience in claims handling
PREFERRED
Health Insurance industry
EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY
REQUIRED
FAIS
REQUIRED
Grade 12 – Matric
PREFERRED
RE5 certificate
TECHNICAL SKILLS OR KNOWLEDGE
REQUIRED
Computer literate, including Microsoft Access and Intermediate Excel Skills.
PREFERRED
Experience on MIP system
Additional Information PERSONAL ATTRIBUTES: COMPETENCIES
- Sound knowledge and experience in the provision of Occupational Health and Primary Healthcare, IOD and medical emergencies
- Conducting medical surveillance examinations
Interpret and record medical surveillance findings and refer medical surveillance findings to Occupational Health Medical Practitioner
- Document management
- Health Risk assessment knowledge
- Ensure legal compliance of on-site clinic
- Qualifications: Professional Nurse and a Qualification in Occupational Health will be an advantage
- Up to date and relevant registration with SANC, SASOHN and DoH
- Certificate in dispensing, audiometry and spirometry
- Computer literacy (Ms Office, Word, Excel, Outlook and PowerPoint).
- Customer orientation, focus on excellence and teamwork
- Ethical behaviour
- Excellent communication skills
Good to know
What does this admin job pay?
This listing does not state a salary. As a guide, admin roles in South Africa typically pay R8 000 to R20 000 a month (indicative).
Do I need experience for admin jobs in Randburg?
This admin role may ask for some experience or a relevant qualification. Read the listing for the specifics before you apply.
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