Enrollment and Benefits Manager

1 week ago

Nelspruit, Mpumalanga, South Africa The Talent Room Full time

The Talent Room seeks a highly skilled Enrollment and Benefits Manager to oversee the enrollment, maintenance, and servicing of all members and employer groups.

This role ensures accurate processing of member applications, updates, and terminations, contributing to achieving effective actions and assistance to the Scheme, other departments, members, and groups to acquire new members, retain existing profitable employer groups, reduce fraud and abuse, and drive sustainability using strategic objectives and key performance areas with measurable outcomes.

Main Responsibilities:

Membership Management and Administration

  1. Process new membership applications, renewals, terminations, and suspensions accurately and within set timelines.
  2. Maintain up-to-date member records and databases to ensure accurate scheme reporting.
  3. Verify and validate member details, dependents, and supporting documents for completeness and accuracy.
  4. Issue policy documents to new and existing members in a timely manner.
  5. Collaborate with Client Relations and Subscriptions to prepare welcome packs and invoices for groups.

Customer and Member Support

  1. Liaise with brokers, employers, and individual members to resolve membership-related issues.
  2. Address member and group inquiries, complaints, and concerns regarding policy benefits, contributions, coverage, and renewal terms.
  3. Conduct risk analysis of new prospective members and groups.

Data Integrity and Management

  1. Review all group contracts to ensure validity and standardization on Novus.
  2. Manage duplicate memberships.
  3. Handle special dependents (children over 21 and 60 years and older).

Verification and Accuracy

  1. Ensure correct fees.
  2. Verify that terms and conditions are included in contracts.
  3. Annual student verification and proof of study.
  4. Maintain electronic and physical member records according to data protection policies.
  5. Support membership account reconciliations and resolve discrepancies with finance teams.

New Employer Groups

  1. Generate contracts and addendums.
  2. Process negotiations.
  3. Create group profiles.
  4. Oversee renewal processes.
  5. Conduct quarterly and annual group reporting.
  6. Handle contract extensions.
  7. Carry out additional tasks assigned by management.
  8. Support major non-day-to-day projects when needed.
  9. Provide training sessions for Client Relations and other departments.
Requirements
  1. Ability to work under pressure and meet deadlines.
  2. Familiarity with working in a fast-paced environment with high accuracy rates.
  3. Ability to work independently and as part of a team.
  4. Necessary organizational and coordinating skills.
  5. Confidential handling of sensitive information.
  6. A professional demeanor.
  7. Compliance with Scheme rules, protocols, and processes.
  8. Detailed attention to accuracy in membership data processing.
  9. Excellent communication skills for engaging with members and stakeholders.
  10. Customer service orientation for timely assistance to members.
  11. Data management and accuracy for maintaining updated membership records.
  12. Analytical problem-solving skills for resolving membership issues.
  13. Knowledge of regulatory compliance and medical insurance laws.
  14. Proficiency in CRM systems and Microsoft Office.
Qualifications
  1. Matric as a minimum requirement.
  2. Prior experience in membership administration and healthcare insurance is advantageous.
  3. At least 2 years of administrative data capture experience or the ability to work quickly and accurately.
  4. Knowledge of medical insurance products, membership databases, and claims processing systems would be beneficial.
  5. Computer literacy and Microsoft Office proficiency are mandatory requirements.

Become a part of our team today

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