Disability & Dread-Disease Claims Specialist

Momentum; Cape Town; On-site; ZAR 240,000 - 360,000; Full time

Job summary

Momentum in Cape Town seeks a claims processor to assess and manage disability, dread disease and income disability claims with a medical component. You will partner with stakeholders to improve the client experience and support policy processes while maintaining accurate records and complying with legislation.

Leveraging knowledge of claims rules and processing systems, you will contribute to continuous improvement and provide timely reporting for management and clients.

Qualifications

• Grade 12 or equivalent essential.
• 1-2 years experience in processing claims essential.
• Knowledge of relevant legislation and industry regulations.
• Knowledge of the claims assessment process (paper and EDI).

Responsibilities

• Assess, review and manage disability, dread disease and income disability claims with a medical component per SLAs.
• Collaborate with stakeholders to improve claims assessment and client experience.
• Contribute to procedures and processes for quality and service improvement.
• Keep accurate records of all claims assessed per legislation and business expectations.
• Stay updated on regulatory changes affecting claims processing.
• Identify opportunities for cost reduction, quality improvement and systems enhancements.

Skills

Claims processing

Regulatory knowledge

Stakeholder collaboration

Education

Grade 12

Relevant degree/qualification

Tools

EDI systems

Claims operating systems

Job description

Momentum in Cape Town seeks a claims processor to assess and manage disability, dread disease and income disability claims with a medical component. You will partner with stakeholders to improve the client experience and support policy processes while maintaining accurate records and complying with legislation.

Leveraging knowledge of claims rules and processing systems, you will contribute to continuous improvement and provide timely reporting for management and clients.