Claims Processing Manager
3 weeks ago
- Develop and implement plans for the section that support Pension Administration and the company's objectives, ensuring optimisation of current business and workflow processes.
- All benefit processing activities in accordance with the benefits as defined in the rules of the Fund and applicable legislation.
o Fund valuation and all audits
- Provide interpretation advice on the application of the Rules of Fund.
- Ensure that audit controls are in place and audit requests are followed up.
- Participate on the defined Committees (Benefits Committee (BC), Medical Panel (MP), Management Benefits Committee (MBC)) and take decisions based on formal documentation.
- Participate in the Funds overall projects as required with continuous focus on Business Processes, system enhancements, omni channel business insight, contributing expertise to enable project objectives to be met.
- Draft reports as part of the project deliverables.
- Contribute ideas for improved service delivery at Management meetings.
- Compile comprehensive business reports for this function, highlighting successes and risks in terms of achieving the sections objectives.
- Keep abreast with changes in relevant guidelines and other legislation, to make recommendations where policies and procedures need to be amended.
- Manage investigations on death benefit cases confirming dependency with recommended benefits allocation percentages for approval by Benefits Committee.
- Monitor that outstanding banking details for payment of approved death benefits are followed up, and confirmed.
- Verify that death benefits allocation reports produced are legally compliant with recommendations and reflect minimal errors.
- Implementation of decisions, requests and referred cases, with reports and recommendations being submitted to BC, MP& BP or other internal departments.
- Ensure compliance with Fund rules and legislation to suspension, addition, termination and reinstatement of beneficiaries (widows and minor children) in compliance.
- Forecast annual capital and operational expenses for the section in line with corporate policy.
- Manage costs against approved budget.
- Investigate methods to contain / reduce costs.
- Ensure compliance to procedures and relevant legislation
- Provide detailed, accurate information for internal and external audit purposes within specified deadlines.
- Action audit issues identified within time frames indicated.
- Implement controls within the section which minimize potential risk to stakeholders.
- Relevant Bachelors Degree, preferably in Law. Registered with professional bodies - where applicable
- At least 6 years job-related experience, which should include at least 2 years experience in a management role
- Knowledge of an African Language is an advantage
- Working knowledge of Pension Fund Rules
- Basic knowledge of Income Tax Act, Divorce Act, Pension Funds Act, Child Care Act, Marriage Act, Recognition of Customary Marriage Act, Mental Health Act
- Working knowledge of Benefit administration
- Knowledge of Law - Section 37 (C) allocation of death benefit lump sums
- Valid drivers license
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