SUMMARY:
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POSITION INFO:
CLAIMS ASSESSOR Location: Pretoria East, Gauteng Position Type: Permanent | Full-Time Industry: Healthcare | Medical Scheme Administration Salary: Market-Related About the Opportunity Medical Resources Group is recruiting on behalf of our client for an experienced Claims Assessor to join their healthcare team. The successful candidate will ensure medical claims are assessed accurately and in accordance with applicable benefit and tariff structures , and that claims are processed and paid correctly. Key Responsibilities Assess medical claims according to the applicable rules and benefit structures. Ensure claims are processed accurately and paid correctly. Apply relevant medical scheme benefit and tariff structures when assessing claims. Ensure claims are assessed in accordance with established processes and requirements. Maintain accurate administrative records relating to claims. Provide appropriate customer service and assistance where required. Apply strong attention to detail when reviewing and processing claims. Ensure all administrative requirements relating to claims are completed accurately and efficiently. Minimum Requirements Grade 12 \/ Matric Minimum 2 years’ claims assessing experience within the Medical Aid \/ Medical Scheme industry. Key Skills & Competencies The ideal candidate will have: Strong computer literacy. Good administration skills. Excellent customer service skills. Strong listening skills. High attention to detail and accuracy. Ability to work efficiently within a structured environment. Good communication and interpersonal skills. Ability to interpret and apply relevant rules and requirements. How to Apply Interested candidates are invited to submit their CV and supporting documentation to: Subject Line: Claims Assessor – Pretoria East, Gauteng Only candidates who meet the minimum requirements and relevant experience will be considered. If you do not receive feedback within 2 weeks of submitting your application, please consider your application unsuccessful.
