Claims Administrator (TSRF)

2 years ago4139 views
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General Details
Advertised By:Agency
Company Name:Salt Employee Benefits
Job Type:Full-Time
Description

The Claims Administrator is responsible for the accurate processing of the deaths and disabilities’ 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 (35 assessments and processing of claims 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
  • Process payments of death claims once approved by Trustees within the latest agreed service levels

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, analyse and present ad hoc reports as and when requested

QUERY RESOLUTION

  • Attend to queries or inquiries by members, employers and beneficiaries within the required timelines – 48 hours

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 and quality assessments, and payments daily.
  • 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 advantag...
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