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.

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

SPECIAL REQUIREMENTS

Good communication skills


Analytical ability


Time management


Team work


Customer focus


Data capturing experience

Qualifications

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

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

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