Claims Administrator
Found in: Talent ZA C2 - 2 weeks ago
The Claims Administrator is responsible for the accurate processing of the claims, within the agreed service level agreement between SALTEB and the Fund and meeting production standards. The duties includes requesting information and responding to enquiries.
Areas of Responsibility
- Ensure that all quality assurance related activities as set out in the Quality Assurance checklist have been actioned.
- Ensure completion of the quality assurance process as set in the Quality assurance checklist
- Contact member for outstanding requirements and update notes on the system
- Calculate the benefit
- Apply for a tax directive
- Prepare the payment requisition
- Ensure the bank details have been accurately captured onto the members record and verified by the bank
- Ensure all relevant documentation are saved onto member’s record.
- Ensure all relevant checks are done on the system before processing a claim
- Meet production standards in terms of quantity (100 assessment daily including payments of 25-30 claims to tax daily
- Should a query raise at any point, complete the investigation and delegate to responsible party to resolve
- Ensure compliance to all control in the teams (switches, merges etc.)
- Devote your whole time and attention and abilities during working hours to the discharge of your duties with strict accuracy
- Ensure all email communication , whether internal or external are dealt with professionally within service level agreement
RECORD KEEPING AND FILING
- Ensure all documentation relating to a claim are saved in the member profile on the system
- Ensure appropriate notes are recorded in the member profile on the system
REPORTING
- Prepare, analyze and present ad hoc reports as and when requested
QUERY RESOLUTION
- Attend to queries or inquiries by members within the required timelines
RELATIONSHIP MANAGEMENT
- Build and maintain positive relationships with all clients and service providers
- Build and maintain supportive relationships with teams internally
- Ensure that all communication sent internally and externally is dealt with professionally
TIME MANAGEMENT
- Meet production standards in terms of quantity (100 assessments daily inclusive of payments).
- Manage work inflow timeously
EDUCATION, LANGUAGE AND QUALIFICATIONS
- Matric with Mathematics/Accounting
- Excellent command of English
- One vernacular language will be advantageous
- RE1 FAIS will be advantageous
ESSENTIAL KNOWLEDGE, SKILLS AND EXPERIENCE
- At least 2 years’ experience in similar position
- Employee Benefits/Retirement Fund industry experience is essential
- Everest experience will be advantageous
- Intermediate MS Excel skills
- Problem solving skills
- Attention to detail
- Good communication skills (written and verbal)
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