Claims Verifier - FTC

Discovery – Health | Claims Services  

Claims Verifier - FTC

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Claims Services 

Claims Services is the central hub for all claims functions from capture to remittance advice distribution and managing the claims lifecycle efficiently and accurately through functional development, leveraging research and best practices to drive strategic initiatives across the Discovery Health composite. Our mission is to ensure seamless delivery of these initiatives while supporting daily operational management. The unit includes Specialised Claims, handling complex and high-value claims with expertise; Claims Processing, capture and verification of claims as well as manual reworks; and Claims Enablement, providing tools and support to enhance operational efficiency. These functions collaborate to deliver exceptional claims services, ensuring optimal outcomes for our clients.

Key Purpose

Verify and capture faxed, scanned or emailed claims within a required time frame and at a required quality level.

Key Output

The successful applicant will be responsible for but not limited to the following job functions:

• Verify and capture faxed, scanned or emailed claims within a required period and at a required quality level.
• Daily assessing of paper or image claims
• Collection, completion and returning of batches within stipulated times
• Achieving of daily target on Verify Processes

Personal Attributes and Skills

The successful candidate would need to have the following competencies:

• Delivering results and meeting customer expectations
• Analysing and following instructions and procedures
• Planning and organizing skills
• Coping with pressure and setbacks
• Adapting and responding swiftly to change
• Adhering to principles and values
• Working with people
• Computer literacy skills
• Excellent written communication skils
• Numerical skills

Education and Experience

The following requirements are Essential:

• Matric
• Basic MS Office knowledge and experience

The following requirements are advantageous:

• Knowledge of relevant legislation, regulations, agreements, acts and policies
• Knowledge of claims assessing in the medical aid industry
• Knowledge of Discovery systems

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.