Role Purpose Preliminary analysis and investigation of allegations related to fraud, waste, and abuse within the medical claims environment. Requirements QUALIFICATIONS - Matric - Bachelor's degree, diploma or higher certificate in a relevant field (e.g., healthcare, law, auditing, forensics) - Association of Certified Fraud Examiners (ACFE) - Certification in fraud examination, healthcare...
GENERAL JOB INFORMATION: We have an exciting opportunity for a Death Claims section 37C Specialist. QUALIFICATIONS AND EXPERIENCE: A minimum qualification of matric. Tertiary education will be an advantage. • At least 5 years' overall experience in Employee Benefits. • An excellent working knowledge of section 37C of the Pension Funds Act and up- to-date knowledge of Adjudicator...
What will you do? Under general direction, researches, collates, records and examines coverage information to make highly complex short term claim settlement determinations. Within company guidelines, approves or denies payment. May assist in training lower-level Claims Clerks. What will make you successful in this role? Qualification and Experience Grade 12 with 3 to 4 years related experience....
Who are we? The Sanlam Retail Affluent business (SRA) is dedicated to empower South Africans in the middle- and upper-income segments to be financially confident, secure and prosperous. With deep client understanding and a focus on excellence in technology, client and intermediary experiences, SRA delivers financial solutions including comprehensive financial planning, life- and disability...
Introduction- Momentum Health, an entity of Momentum Group ,delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximize lifetime client value. We build and maintain a culture of innovation, and create value through unique insights into how to achieve specific outcomes by using a defined set of Health capabilities. Disclaimer- As an...
Claims Management - Receive, review, and process claims from customers, suppliers, and carriers. - Investigate claims by gathering supporting documentation such as delivery notes, waybills, proof of delivery, photos, and incident reports. - Verify claim validity against contractual terms and transport agreements. - Maintain accurate records of claim details, actions taken, and...
CONTRACT CONTRACT CONTRACT CONTRACT CONTRACT CONTRACT CONTRACT Fraud/Claims with Online Purchases: Seeking a contractors to start immediately to handle Claims on Online purchases, be responsible for investigating customer refund claims, identifying fraudulent claims, and contacting customers who display unusually high claims rates. Requirements: - 2-3 years of experience in fraud...
Designation: Claims Consultant | Plattekloof, Western Cape | Permanent Category: Administration and Operations Job Level: Skilled technical and academically qualified workers, junior management, supervisors, foremen and superintendents Posted by: PSG Financial Services Posted on: 19 Dec 2025 Reference Number: POS40234 Closing date: 05-Jan-2026 Position...
Our client is seeking a detail-oriented and organized Claims Clerk to join their transport operations team. This role focuses on managing customer and carrier claims related to the movement of goods, including shortages and damages occurring within the transport process. The position specifically handles logistics and transport-related claims (not insurance claims), ensuring timely resolution,...
Job ID:14131Position Type:Full-TimeJob Function:Financial Services / AnalyticsWorkplace Type:Head OfficeDivision:TFG Financial ServicesProvince:Western CapeLocation:Cape Town NorthSuburb:Parow (Parow)Position Description:Claims Assessor: Insurance A challenging position exists within Financial Services for a claims assessor who is numerate, organised, thorough and a competent individual. Your...
Working in the (Dutch) customer services department- Recording, handling and following up clients’ claims concerning their insurance- Identifying and processing claims using procedures that have been put in place- Evaluating damages according to insurer’s guidelines as well as directly with the client in as far as reimbursement proposals are concerned Skills and Requirements: - Excellent...
Duties & Responsibilities- Claims Administration- Administer complete claims process according to defined claims procedures until claims are settled- Ensure accurate and timely claims processing- 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...
About the job Dutch Claims Administrator Dutch Claims Administrator Join a specialist insurance services provider supporting Dutch-speaking clients from Cape Town. Customer Services | Office-based (Epping) | R15,000 -R18,000 | Mon -Fri, 08h00 -16h45 About Our Client Our client is a reputable and growing international service provider that supports insurance clients in the European market....
A consulting services firm in Cape Town is seeking a Customer Service Representative. You will be responsible for managing claims, ensuring transaction quality, and maintaining customer satisfaction through effective communication. This entry-level role requires attention to detail in managing claims and adherence to operational policies. Join us in delivering excellence while achieving assigned...
Overview We are building a proactive talent pipeline for future demand in our UK operations. While this is not an immediate vacancy, we are connecting with experienced professionals who are ready to step into a dynamic role as soon as the need arises. Role Overview As a Short Term Insurance Claims Administrator, you will provide end-to-end claims support across Commercial, Personal, and Motor...
Overview Role Purpose: Efficiently and effectively manage allegations related to fraud, waste, and abuse within the medical industry. This role involves receiving, analysing, and investigating allegations, validating their credibility, and assessing the need for further action. The Assessor will also provide critical support in data retrieval for internal and external...
About Sanlam CorporateOur vision is to be the preferred partner to Corporate and Public Sector by providing an awesome client experience and comprehensive solutions that enable the financial resilience and prosperity of those entities and their employees. We tap into over 100 years of expertise to provide cost-effective Employee Benefits and Healthcare Solutions that enable financial confidence...
Job description Working in the customer services department Recording, handling and following up clients’ claims concerning their insurance Identifying and processing claims using procedures that have been put in place Evaluating damages according to insurer’s guidelines as well as directly with the client in as far as reimbursement proposals are concerned Skills and Requirements:Excellent...
CAREER OPPORTUNITYSantam Legal Claims Solutions has a position available for a CLAIMS HANDLER who will be based in BELLVILLE, GLACIER BUILDING. The position requires the skills of a dynamic individual who has experience in Short Term Insurance, specifically in a Legal, Claims environment, as well as being fully competent in the third-party indemnification process. The following accountabilities...
A leading insurance provider is seeking a Field Assessor for Heavy Commercial Vehicle claims. The role involves assessing and managing claims, negotiating settlements, and requires qualifications in mechanical or automotive studies. Ideal candidates will have extensive experience in Heavy Commercial Vehicle claims and strong communication skills. Join a company dedicated to diversity and...