QHAWE AWONKE CHRIS MBOVU

➢ To adhere to the claims process and guidelines as laid down in terms of TCF(Treating Customers Fairly) for Medical Aid clients.

➢ To verify and update, if necessary, the client contact and medical aid information on the policy record as per the claim documents submitted.

➢ Verifying of claim documents received and requesting of any outstanding information from the client or broker.

➢ Capturing of the claim details as per invoices and medical aid statements received.

➢ Ensuring valid claims are accurately assessed & paid in accordance with GAP cover policy terms & conditions

➢ Ensuring clients are kept informed and their claim expectation is adequately addressed and managed by communicating or interacting timeously and professionally with our clients telephonically and via e-mail. with the correct template selection and use in your correspondence.

• Assisting members and providers with claims enquiries
• Assisting in solving members and providers queries
• Attending to member's membership enquiries
• Assisting with confirmation of medical aid benefits
• Assisting with medical aid registration enquiries
• Assisting providers with claims related payment queries

• Preassessing & processing of medical claims electronically

• Assist with new maintenance applications
• Assist with substitution of existing new maintenance files
• Attending to maintenance enquiries from the members of the public
• Doing filing of maintenance files
• Writing out subpoenas and summonses for court appearances
• Assisting attorneys with further particulars for court case preparations
• Doing assets verification

• Doing a financial needs analysis to determine a client's affordability of an insurance plan
• Thorough checking & recording of application forms to be submitted
• Setting up appointments with clients on behalf of financial advisors
• Doing office admin, filing, faxing and photocopying
• Making calls to clients about unpaid insurance policy premiums.
• Requesting client policy information from insurers
• Assist with client queries and claims