Position: Claims Assessor
Company: Momentum Health Solutions (Part of Momentum Metropolitan Holdings)
Location: Centurion, Gauteng, South Africa
Reference: MMH250707-9
Type: Permanent
Closing Date: 16 July 2025
Overview:
Momentum Health Solutions is looking for a Claims Assessor to manage and evaluate living benefit claims (such as disability, critical illness, and income protection) in line with legal and internal guidelines.
This role plays a key part in delivering timely, fair decisions while meeting service expectations for clients and stakeholders.
Purpose of the Role:
To assess and process living benefit claims efficiently and accurately, ensuring compliance with policies and regulations, and providing excellent service to clients.
Minimum Requirements:
Grade 12 or equivalent with at least 60% in Maths or Maths Literacy
2 years’ experience in claims processing
Experience with insurance or medical aid claims (manual or electronic/EDI) preferred
Relevant tertiary qualification is advantageous
Familiarity with relevant laws, claims processes, systems, and scheme rules
Key Responsibilities:
Internal Operations:
Assess and manage claims related to disability and critical illness
Work closely with internal teams and stakeholders to improve processes
Keep detailed, accurate records of all claims handled
Monitor industry trends, legal rulings, and policy updates that may impact claims
Identify and recommend process improvements to enhance service delivery
Assist with system updates and testing as needed
Review policies and documents to ensure alignment with regulatory changes
Provide timely reporting and analysis of claims data
Client Service:
Act as a subject matter expert for clients and colleagues
Build and maintain strong relationships with both internal and external stakeholders
Meet service agreements and help improve the customer experience
Support a client-focused culture and encourage customer feedback
People and Development:
Maintain strong team collaboration
Take part in change initiatives and ongoing learning
Stay up to date with industry trends and regulations
Share ideas and contribute to innovation
Take ownership of your career growth
Financial & Risk Management:
Support cost-saving efforts and efficient resource use
Help identify risks and contribute to mitigation strategies
Use company resources responsibly
Assist in planning and budgeting within the team
Core Competencies:
Analytical thinking and attention to detail
Strong communication and teamwork
Decision-making and time management
Accurate data handling and documentation
Understanding and interpreting claims information