Portia Zwane

As a Gap cover Claims Assessor, I ensure claims data is accurately received and processed from medical schemes. I assess claims based on guidelines and protocols, finalize them for quality assurance, and address potential fraudulent claims while managing client queries.

In my role as a Gap Claims Pre-Assessor, I validate personal and clinical information for claims, request outstanding documentation, and ensure claims are loaded correctly according to product specifications.

As a Funeral and Accident/Hospital Cashback Claim Assessor, I processed claims using ICD-10 and CPT codes, liaised with external parties for necessary documents, and analyzed claims for approval or rejection.

In my position as a Gap cover Client Liaison Consultant, I analyzed claims, communicated outcomes to brokers, handled queries, and created reports while ensuring timely responses to client communications.