Are you a detail-driven professional with a passion for claims processing? Look no further – we have exciting opportunities and are seeking skilled individuals to join our growing team.

Claims Officer - Verification & Processing - Qualifications & Experience and Responsibilities 

• HSC 
• Minimum 2-5 years of experience in insurance/medical field 
• Computer literate 
• Communication skills 
• Data Capturing skills 
• Customer centric 
• Health and Medical Knowledge

1. Claims Verification of all schemes administered at Medscheme 
2. Ensure that the SLAs of all schemes are respected for outpatient claim refunds, provided that all relevant information is complete 
3. Meet the department’s quality standards, including an agreed accuracy rate of 95% for outpatient claims. Responding to Requests and Inquiries from Internal and External Parties
4. Follow-up on emails, reply professionally and accurately to both internal departments and external parties
5. Respond to emails promptly, ideally within 48 hours, as and when required
6. To data outstanding claims provided by the Team Coordinator or Team Leader
7. To data & verify payless claims as and when requested by the Team Coordinator or Team Leader