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Health Claims Administrator at Kaelo

--Powermax General Electrical Merchants Ltd--

Job 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.

Job Industry

Healthcare & Insurance

Job Salary Currency

Job Salary Fixed

No

Key Deliverables

  • 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

Essential Qualities

Essential Qualities
  • Ad hoc functions as required by management
  • Good communication skills
  • Analytical ability
  • Time management
  • Team work
  • Customer focus
  • Data capturing experience

PERSON DETAILS: WORK EXPERIENCE

REQUIRED

  • Insurance industry experience
  • 2-5 Years experience in claims handling

PREFERRED

  • Health Insurance industry
  • EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY REQUIRED FAIS
  • Grade 12 – Matric
  • PREFERRED RE5 certificate

TECHNICAL SKILLS OR KNOWLEDGE

  • Computer literate, including Microsoft Access and Intermediate Excel Skills.

PREFERRED

  • Experience on MIP system
  • Additional Information
  • Accountability
  • Action orientated
  • Collaborative
  • Communication
  • Business writing skills
  • Manage complexity
  • Problem solving skills
  • Decision thinking
  • Encourages engagement
  • Resilient and adaptive
  • Resourceful
  • Demonstrates self-awareness
  • Purpose driven
  • Significance and values orientated

Application Process

Close Date

07/03/2025

Apply Now!