Junior Claims Assessor

Job Description,To perform and manage the end-to-end assessment of insurance claims by handling administrative tasks, validating short-term and long-term claims, and ensuring compliance with documented processes., Requirements,Medical qualification (Physiotherapist or Occupational Therapist or BA Psychology; Behavioural Science/Sociology or related)1 - 2 years experience in the assessment of insurance claims is advantageousWorking experience in a medical aid environment or medical insurance environment would be an advantageData analytics would be an advantageBasic computer skills., Duties and Responsibilities,Perform administration tasks related to the assessment of long term claims.Assess and valid date short term and long term claims.Follow claims communication matrix.Synopsise available information.Communicate with brokers, members and internal staff when the need arises to discuss the progress of claims, claims process, confirm information or request additional information.Ensure claims are assessed in line with the documented processes.Prepare cases for discussion with Team Manager/medical officers when required.Prepare cases for presentation at MOC.Able to read and understand reports.Ability to self-manage time and work requirements.Apply medical knowledge to the assessment of claims.