TRAFFIC
Gauteng
Senior Escalation Specialist, Complex Claims
Private Health Administrators (Pty) Ltd
Job Description
A healthcare administration company is seeking an Escalation Officer to manage complex disputes and grievances not resolved by standard customer service methods. The ideal candidate will have 3-5 years of experience in claims or customer escalation, with a preference for backgrounds in medical schemes or insurance. Key responsibilities include case management, root cause analysis, and ensuring compliance with regulations. Exceptional soft skills in conflict resolution and negotiation are essential for this role.
About This Role
Career insights for Claims Adjusters, Examiners, and Investigators positions
Salary Benchmark
$75,050/year
Source: O*NET (USD)
Key Skills for This Role
Reading Comprehension
Active Listening
Critical Thinking
Speaking
Judgment and Decision Making
Common Technologies
Claims processing administration and management software
Microsoft Access
Tropics Claims Reserve Management
Zoom
Datanex ClaimTrac
Document management system software
Hyland OnBase Enterprise Content Management
Axonwave Fraud and Abuse Management System