Claims Specialist
Reference Number: MMH250707-15
Closing Date: 17 July 2025
Employment Type: Permanent
Location: Centurion, Gauteng, South Africa
Remote Work: Some remote work allowed
Department: Client Services
Business Unit: Momentum Health (Part of Momentum Metropolitan Holdings)
Purpose of the Role
To ensure accurate and efficient assessment and processing of medical aid claims while delivering exceptional client service and resolving queries effectively.
Minimum Requirements
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Matric (Grade 12)
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Claims School training (mandatory)
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Computer literacy: Proficient in Word, Excel, and email systems
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Experience:
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1–3 years in the medical aid industry
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2–3 years in claims processing
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2–3 years in client service or query management
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Knowledge of Momentum Health systems (advantageous)
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Understanding of PMB processes, CMS, BHF, and private hospital claims (advantageous)
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Tertiary qualification (advantageous)
Key Responsibilities
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Assess and process medical aid claims accurately
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Record client interactions and queries on relevant systems
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Handle client queries efficiently and escalate where necessary
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Collaborate with departments to ensure timely query resolution
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Identify and report risk concerns
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Support service level agreements to enhance client retention
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Uphold company values in day-to-day work
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Take ownership of personal development through training
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Contribute to team collaboration and initiatives
Core Competencies
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Analytical thinking and mathematical reasoning
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Client-focused with a commitment to quality service
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Business acumen and operational efficiency
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Problem-solving and decision-making
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Effective communication (written and verbal)
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Ability to work independently and in teams
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Adaptability to change and innovation
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Cultural awareness and inclusiveness
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