Medical Insurance jobs in Cape Town, Western Cape

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.