Medical Insurance Company jobs
- KeenCape Town, Western Cape
- Our teams support complex software, insurance, and ecommerce platforms used by businesses around the world.
- 1–2 years of experience in claims handling, claims…
- View all Keen jobs - Cape Town jobs - Insurance Specialist jobs in Cape Town, Western Cape
- Salary Search: Insurance Claims Specialist salaries in Cape Town, Western Cape
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- KaeloRandburg, Gauteng
- Interpret and record medical surveillance findings and refer medical surveillance findings to Occupational Health Medical Practitioner.
- View all Kaelo jobs - Randburg jobs - Health Services Administrator jobs in Randburg, Gauteng
- Salary Search: Health Claims Administrator salaries
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- TransPerfectCape Town, Western Cape
- Final Eye Specialists are key players in the final step of a translation project, assisting the Project Managers with ongoing jobs, assessing project specs and…
- NJ PLACEMENT CONSULTINGRosebank, Western Cape
- Amazing chance to join a Software Development company that develops software for the insurance industry.
- They are a medium size company that look after their…
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- Afrika TikkunSandton, Gauteng 2196
- Onboard new employees onto the group medical and/or insurance benefit.
- Terminating existing employees from the company group benefit.
- NBC HoldingsEastern Cape
- Adhere to company procedures and standards.
- Courses in insurance (CISR or CEBS).
- The Administrator will efficiently and effectively carry out all administrative…
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- AngloGold AshantiJohannesburg, Gauteng 2198
- Medical insurance, employee assistance programmes, and wellbeing initiatives.
- Annual leave, sick leave, and public holidays in line with company policy.
- My Office ManagerHome Based
- Process medical collections and billing, collaborating with healthcare and insurance providers for proper documentation.
- Knowledge of EHR and billing software.
- SanlamCape Town, Western Cape
- Relevant qualification Short term insurance – NQF 4 or if applicable, FAIS credits.
- Membership to funds and schemes, including medical aid, group life & pension…
- SageJohannesburg, Gauteng
- Job Description As a Recruitment & Onboarding Specialist, you will be responsible for managing the full journey of prospective accountants from initial enquiry…
- SageJohannesburg, Gauteng
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- GVW Group, LLCDurbanville, Western Cape 7550
- Maintain insurance, regulatory, and compliance records.
- Maintain organized contract and compliance files in accordance with company policies.
- Dis-Chem LifeSandton, Gauteng
- Contact clients and schedule medical appointments with 3rd party providers.
- This role ensures that insurance applications are processed efficiently, risk is…
- Swiss ReJohannesburg, Gauteng
- Deep financial and medical underwriting expertise, with the ability to evaluate sophisticated and high-value cases.
- Momentum HealthSandton, Gauteng
- Excellent understanding and proficiency in the medical aid industry.
- Experience in the insurance / related industry (essential).
- GuardriskCape Town, Western Cape
- Minimum 2 years in life insurance underwriting (medical underwritingpreferred).
- Strong knowledge of life insurance underwriting and policy administration.
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Job Post Details
Insurance Claims Specialist - job post
Job details
Pay
- R120 000 - R151 800 a year
Job type
- Full-time
Location
Full job description
About Keen
Keen builds high-performing CX and operational teams for fast-growing tech companies in the U.S. and Europe. Our teams support complex software, insurance, and ecommerce platforms used by businesses around the world.
This is not a traditional call centre role. Our teams handle complex work that requires judgment, product knowledge, and real problem-solving. The environment is fast-paced, data-driven, and performance-oriented. We look for those who can demonstrate strong ownership and accountability in their work, effective communication, collaboration with their team, and a growth mindset.
In return, Keen offers long-term careers, equitable compensation, and the opportunity to work in the future of the customer support industry. As Tier-1 work is automated by AI, Keen teams focus on the complex work that tech companies will always need.
About the Role
We are seeking an experienced Claims Assessor / Claims Specialist to support the accurate and efficient processing of claims within an internal claims platform. The ideal candidate will be responsible for reviewing claim submissions, validating supporting documentation, assessing claims against predefined guidelines, and updating claim outcomes through approved system actions. This position offers a unique opportunity to work in a structured, high-volume back-office environment with a strong focus on quality, accuracy, and turnaround times.
This is a full-time, office-based role located in Salt River.
What You’ll Do
- Review and assess new and reopened claims in line with internal guidelines and settlement authority.
- Process claims exclusively within the internal claims system using approved workflows, templates, and status updates.
- Validate claim information and supporting documents for completeness, accuracy, and eligibility.
- Handle routine claims decisions within defined thresholds and escalate exceptions, appeals, or edge cases to the internal client team.
- Maintain accurate claim records and ensure all required documentation is captured correctly in the system.
- Meet productivity, quality, and SLA targets across daily claims processing volumes.
- Identify potential fraud indicators or inconsistencies and escalate where required.
- Support continuous improvement by flagging process gaps, recurring issues, or workflow inefficiencies.
- Collaborate internally with team leads and quality teams to ensure consistent claims handling standards. Follow all operational, compliance, and documentation procedures relevant to claims processing.
Requirements
What We’re Looking For
- 1–2 years of experience in claims handling, claims assessment, insurance operations, or a similar back-office processing role.
- Experience working in a high-volume, process-driven administrative environment.
- Experience with claims such as travel, ticketing, mobility, shipping, or purchase protection is advantageous.
- Strong attention to detail with the ability to review documentation carefully and make accurate decisions.
- Good written English comprehension and the ability to follow structured processes and guidelines.
- Strong organisational and time management skills.
- Comfortable working within internal systems and managing repetitive workflows with accuracy.
- Ability to identify exceptions and escalate appropriately using edge case judgement.
- Strong written and spoken English (C1 level or higher) and pass a typing speed test of 40+ WPM.
- Calm under pressure with strong problem-solving and communication skills.
- Reliable and punctual, with a demonstrated history of professional attendance and accountability.
- Able to receive feedback, follow structured processes, and operate within defined service standards.
- Proven history of working evening or overnight shifts.
Assessment Disclaimer
- The first stage is a 60-minute assessment with video questions, a typing test, and skill quizzes.
- You will have 24 hours from application submission to complete these.
- You will need access to a PC with a webcam and microphone to complete the assessments.
Schedule & Location
- This role supports international customers and operates on day, evening, and overnight shifts (SAST).
- This is a full-time, office-based role located in Salt River.
- In accordance with local transport requirements, Keen provides transportation to and from the office for shifts starting or ending between 7 pm and 6 am SAST.
Benefits
- Collaborative in-office team environment
- Professional development budget
- Compensation includes:
-
- Base Salary
- Medical Allowance
- Attendance & Timeliness Bonus
- Transport Allowance
- Monthly Performance Bonus
- Total potential monthly earnings: up to R12,650 – inclusive of the above
- Team members who demonstrate strong performance and reliability may have opportunities to grow into roles such as Subject Matter Experts, Team Leads, QAs, or Operations.