Claims Administrator –
Key Responsibilities
• Assess the validity of the claim and documentation
• Invalid claims will be rejected/ Repudiated
• Assure capturing of claims are done accurately
• Assure all criteria is met to pay claim
• Assure the quality of feedback (written and verbal) to clients
• Assure feedback on requirements for successful claims payment is done timeously
• Asses claims for possible fraud risks
• Conduct Quality Audits on peers
• Investigate and resolve internal and external complaints
• Conduct on-the-job training for new staff
R9 000