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Medical Aid Benefits Specialist

4 months ago

Cape Town, Western Cape, South Africa Shoprite Full time

Purpose of the Job

The purpose of the Medical Aid Benefit Specialist is to ensure the smooth functioning of all administration related to the Group's medical aid scheme. The primary responsibility includes the accurate and timelyprocessing of medical aid benefit applications (and any other optional medical aid related products), maintenance of medical aid data and reporting and co-ordination of all administrative requirements necessary for compliance as group medical aid scheme. The role also renders additional ad hoc support services as required within the function.

Job Advert Details Job CategoryHuman Resources Job Objectives

Medical Aid Administration :
Ensure accurate and timely processing of member application forms, changes to existing memberships, and related documentation, communicating outcomes, facilitating the transactional activities
Liaise with Payroll, People Partners, and Medical Aid Administrators to follow up on outstanding information and resolve any discrepancies Sign off on medical aid-related forms (e.g., Dental, Gap, Flexicare, Vitality) and communicate updates to relevant stakeholders
Manage medical aid-related mailboxes and respond to employee queries in a timely manner

Benefits Maintenance and Reporting :
Maintain up-to-date employee benefits records and documentation, including eligibility, dependents, and contribution changes
Generate and distribute monthly and annual medical aid reports, statistics, and invoices to stakeholders
Assist with the annual review and update of medical aid policies, contribution tables, and member communication materials
Prepare files and support the Principal Officer in the annual benefits review process and regulatory submissions

Stakeholder Engagement and Coordination :
Act as the primary point of contact for employees regarding medical aid-related inquiries, changes, and issue resolution
Coordinate and attend regular meetings with Medical Aid Administrators, Payroll, Finance, and other relevant teams to discuss benefits-related matters
Assist in the preparation of agendas, minutes, and supporting documentation for various benefits related meetings (e.g., Admin Meetings, Reconciliation Meetings, Board of Trustee Meetings, Management Meetings, Audit Committee Meetings)
Collaborate with internal and external stakeholders to ensure the effective implementation and communication of benefits programs

Continuous Improvement:
Stay up-to-date with changes in medical aid regulations, policies, and industry best practices
Identify opportunities to streamline benefits-related processes and implement efficiencies
Provide recommendations and input to management on enhancing the organization's benefits offerings and administration

Employee Centric Delivery
Providing administrative support according to benefits policies and procedures.
Adhering to legislation as required by the benefits function.
Escalating concerns or challenges to ensure an efficient flow of work is maintained and coordinating the resolution.
Providing information and empowering the People Support Service Desk with relevant first line inputs to build the capacity within the People Support Service Desk.
Registering new applications, processing and communicating outcomes, facilitating the transactional activities
Compiling and updating documents as required.
Capturing, loading and processing relevant documents on relevant systems.

People (Self, Team & Organisational)
Participating in and aligning with the Benefits team to deliver solutions and services to the business.
Participating in various team activities that foster an innovative, agile and employee centric culture where employees are supported, empowered and valued.
Participating in various team activities that foster a wellness culture to ensure that the Benefits team
mentally, physically and emotionally feels supported.
Participating in enabling a culture of open and transparent communication within the Benefits team.

Financial, Reporting & BI
Ensuring accuracy in data input and relevant reports as applicable to the Benefits team
Using official data sources to inform administrative outputs.
Assisting with compiling basic reports for input to broader Benefits and/or People team requirements.
Consolidating basic costs or data as required

Governance & Compliance
Ensuring compliance with relevant labour relations frameworks and legislation.
Ensuring compliance to organisational and legislative governance frameworks and standards includingthe H&S requirements and POPI Act.
Identifying and mitigation risks.

Future-Fit
Participating in the integration and effective flow of work with other service areas and business.
Identifying opportunities for continuous improvement.
Suggesting or sharing ideas and functional technology requirements where required.

Qualifications

Grade 12, National Senior Certificate - (essential).
Diploma in Administration or equivalent - (beneficial).

Experience

+2 years in an Administrative Benefits role with exposure to supporting the processes related medical aid benefits offerings in a Group structure (essential).
Experience within the FMCG, retail sector or similar - (preferred).

Knowledge and Skills

Connecting & Initiating - Works cooperatively with others and effectively manages disagreements. Works as part of a team and collaborates with others. Invites input and suggestions from colleagues. Shares information that may be useful to others. Handles conflict situations in a constructive way. Makes proactive decisions but refers to others when necessary. Takes responsibility for own work or projects. Gets involved in projects without being prompted and takes on additional responsibilities. Takes initiative to update own knowledge base and skillset.

Executing & achieving - Identifies what needs to be achieved. Establishes priorities and manages time effectively. Creates clear action plans including tasks and timelines. Takes account of possible changing circumstances. Monitors own progress to ensure the accurate and timely completion of work. Sets realistic goals for themselves. Clarifies task requirements and expectations for delivery. Monitors activity to measure progress against set timelines. Ensures tasks have been completed in line with expectations.

Responding & adapting - Remains productive and maintains high levels of performance in a pressurised environment. Remain calm and composed in stressful situations. Can maintain focus in pressurised environments. Maintains a positive outlook believing challenges can be overcome. Perseveres despite setbacks, not giving up prematurely. The ability to embrace uncertainty and adapt swiftly to changing situations. Comfortable working with ambiguity. Adapts to new information and changing conditions. Demonstrates a willingness to change ideas or perceptions based on new information or contrary evidence.

Analysing & Innovating - Works through the relevant details and facts. Makes connections in information identifying how different aspects of a problem are related and possible causes within the context of their role and function. Recognises the need for additional information and works to obtain it. Develops alternative approaches to the prevailing processes. Modifies and adapts current methods and approaches to better meet needs. Displays curiosity and an openness to new ideas. Takes accountability for embracing new processes, methods or systems that are introduced.

Performance & output alignment - Interprets individual performance data to identify areas of poor performance. Co-creates individual performance improvement plans. Aligns functional activities and outputs to the broader People team. Seeks to continuously improve.

Human Capital administration, policies & procedures - Understands the HC administrative processes to process employee data. Generates People orientated documentation in support of HC Approved v1.0 Page 4 of 4processes. Understands the regulatory and policy requirements to maintain and keep employee files and records. Understands the importance of maintaining confidentiality when working with employee information.

Benefits knowledge - with reference to Buying Card, Edu Loans & Long Service Awards.

Processing - Uses the required system within this process. Knows the company process requirements regarding keeping relevant logs, files, and records up-to-date and accurate. Knows the requirements for accurate reporting on process outputs. Knows how to maintain compliance with policy and process requirements.

Governance & ethical behaviour - Applies the Governance Policy, Code of Conduct, and ethical behaviour. Responds to feedback and non-compliance and implements suitable corrections.