19 Healthcare Claims jobs in South Africa

• Make and receive calls to clients
• Gather and follow up all info and documents required to register claims
• Advise on claims under what section covered on policies
• Interact and follow up with Insurers
• Involvement with claims intermediary service (Client satisfaction)
• Follow claims through to Agreement of Loss and signed by client
• Use logic and intellect to ensure customers are treated fairly
• Build trust-based relationships with clients

Key Skills and Competencies:

• Good verbal and written communication skills at all levels
• Computer literate in Microsoft Office and internet
• Self-discipline and time management
• Punctuality

Candidates must have the following qualifications:

• Grade 12

Competence:

• Experience (1+ Years in industry)
• Class of Business completed for STI Personal and Commercial lines
• Operational Ability
• Product Specific Training

The following additional factors will be to your (Candidates) advantage:

• Experience on SANTAM online system
• Product specific training completed with main players in insurance industry: Santam, Old Mutual, Momentum (Previously Alexander Forbes), Bryte et

Main characteristics / strong points for candidates:

• Good verbal- and written communication skills at all levels
• Computer literate in Microsoft office and internet
• Self-discipline and time management
• Punctuality
• Make and receive calls to clients
• Gathering and follow up all info and documents required to register claim.
• Advise on claims under what section covered on policies.
• Interaction and follow up with Insurers
• Involvement with claims intermediary service (Client satisfied).
• Follow claim through to Agreement of Loss and signed by client.
• Logic and intellect to ensure customers treated fairly.
• Build relationships (Trust) with clients

Claims Administration
Administer complete claims process according to defined claims procedures until claims are settled.
Apply policy terms and conditions.
Make assessment of claims validity and estimate value and administer mandated claims.
Act as intermediary between insurer and client and timeously relay communication, requests and documentation.
Engage with insurers regarding recoveries, diarise follow-ups and keep clients informed.
Ensure productivity targets are met.
Contribute towards and ensure continuous improvement in own and team performance.
Adhere to company mandates.
Participate and contribute in ad hoc projects.
Report any suspected fraud, misrepresentation and/or dishonesty.
Keep accurate record of own activities.

RE 5 A MUST

MATRIC A MUST

CREDITS WOULD BE GREAT

Salary: R20 000 - R25 000

• HR Services, Recruitment & Selection

Claims Administration
Administer complete claims process according to defined claims procedures until claims are settled.
Apply policy terms and conditions.
Make assessment of claims validity and estimate value and administer mandated claims.
Act as intermediary between insurer and client and timeously relay communication, requests and documentation.
Engage with insurers regarding recoveries, diarise follow-ups and keep clients informed.
Ensure productivity targets are met.
Contribute towards and ensure continuous improvement in own and team performance.
Adhere to company mandates.
Participate and contribute in ad hoc projects.
Report any suspected fraud, misrepresentation and/or dishonesty.
Keep accurate record of own activities.

RE 5 A MUST

MATRIC A MUST

CREDITS WOULD BE GREAT

Salary: R20 000 - R25 000

• HR Services, Recruitment & Selection

Job Title: Short-Term Insurance Broker – Claims

Location: Durbanville, Cape Town

Salary: Market Related - Negotiable depending on experience

About the Role:

We are seeking an experienced Short-Term Insurance Broker to join our client, a well-established logistics company based in Durbanville, Cape Town. The successful candidate will be responsible for handling and managing all insurance claims (including Heavy Commercial Vehicles and Goods in Transit) within the company. This role requires someone with excellent attention to detail, strong communication skills, and the ability to liaise effectively with insurers, service providers, and internal stakeholders.

Key Responsibilities:

• Manage the full insurance claims process for HCV, GIT, and related policies.
• Liaise with insurers, assessors, and repairers to ensure efficient claims handling.
• Maintain accurate claim documentation and records.
• Provide advice and guidance to management regarding claims and risk matters.
• Ensure claims are processed timeously and in compliance with regulations.
• Build strong working relationships with insurers and stakeholders.

Minimum Requirements:

• 5+ years’ experience in short-term insurance (claims handling essential).
• Strong knowledge of HCV and GIT insurance.
• Fully qualified with RE5, FAIS Credits, and NQF 4 qualification.
• Valid driver’s licence and reliable transport.
• Excellent problem-solving and negotiation skills.
• Professional, trustworthy, and adaptable with strong attention to detail.

Skills & Attributes:

• Strong organisational and administrative skills.
• Ability to work independently and manage multiple claims simultaneously.
• Excellent verbal and written communication skills.
• Proactive, service-oriented, and deadline-driven.

Remuneration:

Basic Salary: Market Related - negotiable depending on experience

Application:

This is a full-time hybrid role for a Medical Billing Administrator at Heartfelt Practice Solutions. The Medical Billing Administrator will be responsible for managing billing processes, invoicing, utilizing billing systems, and applying analytical skills. This role is primarily located in Pretoria but allows for some remote work flexibility.

• Billing Process, Invoicing, and Billing Systems knowledge
• Analytical Skills and Finance background
• Experience in healthcare billing practices
• Attention to detail and accuracy in financial data
• Proficiency in medical billing software
• Excellent organizational and time management skills
• Ability to work independently and in a team
• Relevant certification in medical billing or finance
• Bachelor's degree in any related field

• Preparing and submitting accurate claims
• Following up on claims to ensure timely payment
• Appealing denied claims and resolving claim issues
• Maintaining patient records and account information
• Handling patient billing and collections
• Processing patient payments and refunds
• Generating financial reports and analyzing revenue
• Identifying and resolving billing errors
• Ensuring compliance with healthcare regulations and coding standards

• Strong understanding of medical coding and billing procedures
• Proficiency in medical billing software
• Excellent attention to detail and accuracy
• Strong organizational and time management skills
• Good communication and interpersonal skills

Empowering Africa’s tomorrow, together…one story at a time.

With over 100 years of rich history and positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of an exciting growth journey, to reset our future, and shape our destiny as a proudly African group.

To plan, manage, and monitor the implementation of claims management activities and processes to deliver on approved operational plans effectively and efficiently.

• Claims assessment: Assess and/or process claims following standard operating procedures.
• Customer Experience: Handle all customer interactions professionally and efficiently.
• Ad Hoc duties: Provide support to customers and team as required to ensure team performance on an ongoing basis.
• Compliance and Risk Management: Ensure all team activities adhere to relevant control, compliance requirements, and quality standards.

Further Education and Training Certificate (FETC): Business, Commerce, and Management Studies (Required)

Absa Bank Limited is an equal opportunity, affirmative action employer. In compliance with the Employment Equity Act 55 of 1998, preference will be given to suitable candidates from designated groups to promote equitable demographic representation and diversity within the bank.

Absa Bank Limited reserves the right not to make an appointment to the post as advertised.

Reference: NWI001752-Nikki-1
A respected player in the insurance industry is committed to delivering reliable solutions to our clients. We take pride in our work and are seeking a Claims Manager to join our team in Mozambique.

Responsibilities:

1. Claims Processing: Oversee the end-to-end claims process, ensuring accuracy and adherence to timelines.
2. Team Management: Lead and support a team of claims professionals, promoting a collaborative work environment.
3. Compliance: Ensure compliance with company policies, industry regulations, and legal requirements.
4. Customer Relations: Address inquiries and maintain positive relationships with clients, brokers, and stakeholders.
5. Data Analysis: Utilize data and analytics for trend analysis and process improvement.

1. Bachelor's degree in Business, Insurance, or a related field.
2. Proven experience in insurance claims management.
3. Strong leadership and interpersonal skills.
4. In-depth knowledge of insurance policies and regulations.
5. Analytical and problem-solving abilities.
6. Effective communication and negotiation skills.

If you are interested in this opportunity, please apply directly.

For more information contact:
Nichola Ferreira
Recruitment Agent
+27 12 348 7559