Claims team leader

Position Purpose: The Claims Team Leader is responsible for overseeing the daily operations of the claims processing team, ensuring that claims are assessed, processed, and paid accurately, efficiently, and in line with the policies, guidelines of the medical aid scheme and service level agreements (SLAs). The role also focuses on managing the financial risk associated with claims, enhancing the quality of service to members, and protecting the sustainability of the medical aid scheme.

Experience: At least 1–2 years’ experience in a supervisory or team lead role.

Qualifications: Matric (Grade 12) Relevant qualifications in Healthcare Administration, Business Management, or related field (advantageous). KEY PERFORMANCE AREAS

Claims Processing Supervise the day-to-day operations of the claims department team. Ensure timely and accurate processing of medical aid claims in accordance with scheme rules. Review and authorize high-value or complex claims. Monitor and m...