Discovery Health Claims Assessor | Talent Pool

Date Posted: 25 August 2026
Business Unit: Discovery Health
Function: Claims Administration
Department: Medical Services Organisation
Location: Africa Health Hub
Job Type: Talent Pool Opportunity

About the Talent Pool

By applying for this position, you consent to being considered for Discovery's Talent Pool for future Claims Assessor opportunities.

A talent pool is a database of candidates who have successfully demonstrated that they meet the requirements for a particular position. Once additional positions become available, suitable candidates in the talent pool may be considered before the recruitment process starts again.

Candidates will still be required to complete the applicable recruitment process, which may include:

• Assessments
• Role plays
• Interviews
• Other recruitment activities

Successful candidates who meet the required criteria may remain active on the candidate database and receive monthly updates regarding their application status.

Key Purpose of the Role

The Claims Assessor / Claims Processor is responsible for accurately processing medical service provider claims.

The successful candidate will work as part of a claims team under the supervision of a Team Leader, with the goal of meeting client Service Level Agreement (SLA) requirements while maintaining high standards of accuracy and quality.

Key Responsibilities

The successful candidate may be responsible for:

• Preparing payments and sending remittances to medical service providers.
• Capturing and processing claims according to performance and productivity targets.
• Ensuring claims are accurately processed according to applicable tariffs and member benefits.
• Working collaboratively with team members to achieve client SLA objectives.
• Participating in assigned projects.
• Monitoring individual performance and responding to quality audit feedback.
• Providing managers with detailed feedback on exceptions and escalated matters within the required SLA.
• Managing the validation of claims received.
• Processing paper-based claims received through the mailroom.
• Identifying discrepancies and resolving claims-related issues where required.

Required Competencies

Knowledge

Candidates should have knowledge of:

• Payment processing systems and procedures.
• Healthcare billing codes, terminology and relevant regulations.
• Insurance policies, member benefits and reimbursement processes.
• Claims processing and payment management systems.
• Service Level Agreement (SLA) measurements and targets.

Skills

The successful candidate should demonstrate:

• Excellent attention to detail.
• Strong organisational skills.
• Analytical and problem-solving abilities.
• Effective communication skills.
• Good time-management skills.
• The ability to manage multiple tasks and meet deadlines.
• The ability to identify discrepancies and resolve exceptions.
• The ability to work effectively in a fast-paced environment.

Personal Attributes

Discovery is looking for candidates who demonstrate:

• A commitment to quality and meeting SLAs.
• A proactive approach to improving processes.
• Strong teamwork and collaboration.
• Accountability for individual performance.
• Openness to feedback and continuous improvement.
• Resilience when working under pressure.
• A customer-focused approach.
• Adaptability when dealing with changing requirements.

Minimum Requirements

Education

• Grade 12 / Matric is required.

Experience

• At least 2 years' experience as a Claims Assessor or Claims Processor.
• Experience should ideally be within Managed Healthcare Funding, Health Insurance or Healthcare Administration.
• Knowledge of hospital and medical service provider billing structures and tariffs.
• Knowledge and understanding of procedure and diagnosis coding as it relates to claims processing.
• Call Centre experience would be advantageous.

The Discovery Person

Discovery looks for individuals who demonstrate the following characteristics:

• Values Driven – acts in accordance with strong personal and organisational values.
• Optimistic – maintains a positive and constructive approach.
• Learns on the Fly – adapts quickly and continuously develops new skills.
• Resilient – remains effective when dealing with pressure and challenges.
• Instils Trust – builds confidence through reliability and integrity.
• People Savvy – works effectively with different people and teams.
• Drives Results – remains focused on achieving measurable outcomes.
• Problem Solver – takes initiative to identify and resolve challenges.

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