manager: claims processing

2 weeks ago


Bryanston Johannesburg Ward Sandton City of Johannesburg Metropolitan Municipality Gauteng South Africa H&S Labour Brokers cc Full time

Manage Benefits Investigation and Claims Processing Function

BASIC JOB DESCRIPTION

  • Manage internal departmental functions and processes:
    • Develop and implement plans that support Pension Administration and company objectives, optimizing current business and workflow processes.
    • Conduct benefit processing activities in accordance with Fund rules and applicable legislation.
      • Unclaimed benefits, Evidence of Survival reviews, tracing, and verification.
      • Fund valuation and audits.
    • Provide advice on interpreting Fund rules.
    • Ensure audit controls are in place and followed up.
    • Participate in defined Committees (Benefits, Medical Panel, Management Benefits) and make decisions based on formal documentation.
  • Project Management:
    • Participate in the Fund's overall projects focusing on Business Processes, system enhancements, and business insight.
    • Draft reports as part of project deliverables.

Provide Input to Strategic Management of the Section:

  • Contribute ideas for improved service delivery at Management meetings.
  • Compile comprehensive business reports, highlighting successes, and risks in achieving objectives.
  • Stay informed about relevant guideline changes to make recommendations on policy and procedure amendments.

Oversee Section 37C Dependency Investigations on Death Benefits Allocations:

  • Manage investigations on death benefit cases confirming dependencies and recommending benefit allocations.
  • Monitor outstanding banking details for approved death benefits and confirmations.
  • Verify death benefit allocation reports for legality and accuracy.
  • Oversee Provision of Social Services to Guardian Cases:
    • Implementation of Benefits Committee & Medical Panel decisions and referrals.
    • Ensure compliance with Fund rules and legislation in managing beneficiaries.
  • Financial Management:
    • Forecast annual capital and operational expenses aligning with corporate policy.
    • Manage costs against approved budget.
    • Explore cost containment and reduction strategies.
  • Corporate Governance:
    • Ensure compliance with procedures and legislation.
    • Provide detailed information for audits within specified deadlines.
    • Address audit issues promptly.
    • Implement controls to minimize stakeholder risks.

REQUIRED MINIMUM WORK EXPERIENCE AND QUALIFICATIONS:

  • Relevant Bachelor's Degree, preferably in Law, and registration with professional bodies.
  • At least 6 years job-related experience, including 2 years in a management role.
  • Knowledge of an African Language is advantageous.
  • Working knowledge of Pension Fund Rules, Income Tax Act, Divorce Act, and other related Acts.
  • Basic knowledge of Benefit Administration and Section 37C allocation of death benefits.
  • Valid driver's license required.

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