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The Section 37C, Disability and Funeral Claims specialist administrator is responsible to accurately and timeously perform all Section 37C related activities through the co-ordinating of death, disability and funeral claims information as per agreed service levels between SALT EB and the Fund and support the trustees with the death, disability and funeral claims process whilst meeting production standards.
To provide efficient administration and verification service in respect to quality assurance of risk claims that results in the improvement of client service and to minimize financial risk. The responsibility is to ensure that all claims and related documents conform to the set standards, within the agreed service levels and that the claim is ready for processing.
The duties include requesting information, responding to enquiries and providing assistance to members and beneficiaries, Compliance, Client Services, the Contact Centre, employers and external service providers.
Areas of Responsibilities
KEY ACTIVITIES
Perform all Section 37C related activities which include the complete death claim processing cycle of all death claims, all death related enquiries and complaints.Liaise with members, beneficiaries, employers and/or relevant stakeholders in a professional manner in order to obtain and clarify details regarding the claims (both verbal and written).Quality assure and review the death claim documentation in order to ensure the documentation is accurate, complete and compliant with relevant legislation.Liaise with the relevant affiliations in order to resolve issues around incorrect or incomplete documentation.Prepare investigation report detailing findings together with motivation for the distribution of the benefit for the Trustees to verify and approve at the Death Benefit Disposal Sub-Committee meeting.Prepare a report on death cases for presentation to Trustees at the Death Benefit Disposal Sub- Committee meeting on a monthly basis.Report on inflow and outflow of death claims statistics for Fund.Process payment of death once approved by Trustees within the agreed service levels.Keep abreast of all requirements in the retirement industry as set out by the FSCA and the relevant legislation.Process Section 37C claims according to the rules, policies, legislation, administration procedures and the service level agreement.Provide accurate information to clients in order to ensure that they receive appropriate service.Build and maintain relationships with internal and external stakeholders.Deliver on service level agreements agreed between internal and external stakeholders in order to ensure that expectations are managed with beneficiaries.Make recommendations to improve client service and fair treatment of clients within area ofhttps://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8xNjQ3ODgwNjc1P3NvdXJjZT1ndW10cmVl&jid=161745&xid=1647880675
4h
1
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PURPOSE OF THE ROLE
To receive and perform quality assurance on documents and assessment of claims for legitimacy based on the specialized requirements of the role.To initiate all new claims received on the operating system used by Salt Employee BenefitsTo follow up on behalf of members on all outstanding claim paymentsTo deal with member queries and advise members on fund benefit structure and benefitsTo act as a liaison between the members of the Fund and Fund’s other service providers (funeral benefit administrator, Section 37C Investigators, Trust Fund Administrators, Tracers) in receiving claims and ensuring that they are processed timeously.
Walk in Members
Receive members and help them with submission of claim.
First ensure that the member is a member of the FundEnsure that the member is not still employed in the industryCheck that the contributions are up to dateCheck that all claim documents are available:
Claim documents are completed, signed and stamped by both employer and memberCopy of ID is available and clearCopy of bank statement is available and clearValid Tax number for the member
Advise member if there are any discrepancies regarding the membership or any of the above.Help member to understand what the member needs to do.
Attend to members and beneficiaries who are submitting and following up on their claims (withdrawal, funeral, disability, death, unclaimed benefits, retirement, trust fund)
Ensure that the member’s claim has the necessary documentation and attachments according to type of claim.Escalate claims that are outside the service level agreement.
Advise members who come to enquire about their membership on their statusWhere a member has shown proof that they were employed and the employer has not paid, refer to the relevant CLO/MCLO for further investigation.Provide members with benefit statements, contribution history and quotations where available.Educate members on benefits of the fund and process.Provide a daily report to the manager for consideration and review.
Reporting and Admin
Submit daily and weekly reports.All claims and documents to be uploaded and indexed on Everest/EPIC system used by Salt.
Relationship Management
Strictly adhere to the rules and policies of the Fund, legislation, administration procedures and service level agreements.Maintain and improve quality results by adhering to standards and guidelines; recommend improved procedures.Attend internal and external training required.
Time Management
Excellent time ma...
https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8xODYxODIxOTU2P3NvdXJjZT1ndW10cmVl&jid=1345337&xid=1861821956
4h
1
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PURPOSE OF THE ROLE
The Claims Team Leader is responsible for the overall management of the claims team. The duties include, managing, planning, monitoring and reporting. The Claims Team Leader reports to the Manager: PSSPF Claims.
The ability to investigate and apply expertise to data with an intended objective to deliver on the specific area of expertise.The ability to analyze data and extract trends to ensure improvement of processes and or customer satisfaction. This could be in the form of innovative ideas as well as the task of compiling reports.Engage and list to current challenges in the team/business and use expertise to Trouble shoot issues in order to provide workable solutionsThe ability to tackle a Problem with the intent of using expertise/capability and or experience to resolve speedilyPerform quality assurance based on the specialized requirements of the role.Should be able to ensure strong stake holder management ito Communication i.e. feedback to clients, managing clients, responding to clients, attend to queries timeouslyEngage in a professional manner whether it be verbal or face to faceHave the ability to communicate via different communication channelsEnsure that the brand or image of SEB is always maintained by adhering to the values (in keeping in line with the KPI and values of the company)Be a strong team playerHave both both industry knowledge and experienceEnsure that the role is carried out with the relevant accuracy, attention to detail and following instructions.Ensure that judgement and attention to detail is applied to the roleEnsure that the role is completed within required deadlines and should have the ability to organize, plan, set goals and deliver accordingly.Strong interpersonal skills as cross team collaboration is required.Have the ability to innovate in the roleQuality of work should be thoroughConscious of the abuse of company resourcesThe Section 37C, Disability & Funeral benefits Claims Team Leader is responsible for the overall management of the team. The duties include, managing, planning, monitoring and reporting. The Team Leader is responsible for managing operations of the team in the absence of the manager, including presentation of Board reports to the Board of Management and Sub-committees in the absence of both the manager and CRM.
SPECIALIST REQUIREMENTS
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 checklistContact member for outstanding requirements and update notes on the systemCalculate the benefitApply for a tax directivehttps://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8zOTA5NDkyMjIzP3NvdXJjZT1ndW10cmVl&jid=375920&xid=3909492223
4h
1
SavedSave
PURPOSE OF ROLE
The ability to investigate and apply expertise to data with an intended objective to deliver on the specific area of expertise.The ability to analyze data and extract trends to ensure improvement of processes and or customer satisfaction. This could be in the form of innovative ideas as well as the task of compiling reports.Engage and list to current challenges in the team/business and use expertise to Trouble shoot issues in order to provide workable solutionsThe ability to tackle a Problem with the intent of using expertise/capability and or experience to resolve speedilyPerform quality assurance based on the specialized requirements of the role.Should be able to ensure strong stake holder management ito Communication i.e. feedback to clients, managing clients, responding to clients, attend to queries timeouslyEngage in a professional manner whether it be verbal or face to faceHave the ability to communicate via different communication channelsEnsure that the brand or image of SEB is always maintained by adhering to the values (in keeping in line with the KPI and values of the company)Be a strong team playerHave both both industry knowledge and experienceEnsure that the role is carried out with the relevant accuracy, attention to detail and following instructions.Ensure that judgement and attention to detail is applied to the roleEnsure that the role is completed within required deadlines and should have the ability to organize, plan, set goals and deliver accordingly.Strong interpersonal skills as cross team collaboration is required.Have the ability to innovate in the roleQuality of work should be thoroughConscious of the abuse of company resourcesThe Section 37C, Disability & Funeral benefits Claims Team Leader is responsible for the overall management of the team. The duties include, managing, planning, monitoring and reporting. The Team Leader is responsible for managing operations of the team in the absence of the manager, including presentation of Board reports to the Board of Management and Sub-committees in the absence of both the manager and CRM.
PEOPLE MANAGEMENT
Implement the culture transformation programmed that will enable the delivery of Salt’s strategic intent and identified ideal behaviors to improve employee engagement and reduce employee turnover.
Develop a high performing team by embedding formal performance development and informal coaching. Implement talent acquisition, engagement and recognition process in line with this.
Specialist Requirement :
Ensure that all quality assurance related activities as set out in the Quality Assurance checklist have been actioned.Ensure completion of the qu...
https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS8zNzY5Nzc3MzA5P3NvdXJjZT1ndW10cmVl&jid=1163680&xid=3769777309
4h
1
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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 checklistContact member for outstanding requirements and update notes on the systemCalculate the benefitApply for a tax directivePrepare the payment requisitionEnsure the bank details have been accurately captured onto the members record and verified by the bankEnsure all relevant documentation are saved onto member’s record.Ensure all relevant checks are done on the system before processing a claimMeet 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 resolveEnsure 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 accuracyEnsure all email communication, whether internal or external are dealt with professionally within service level agreementProcess 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 systemEnsure 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 providersBuild and maintain supportive relationships with teams internallyEnsure 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/AccountingExcellent command of EnglishOne vernacular language will be advantageousRE1 FAIS will be advantag...
https://protool.gumtree.co.za/external-link-browser.html?url=aHR0cHM6Ly93d3cuZGl0dG8uam9icy9qb2IvZ3VtdHJlZS80MjgzMjU5NDU3P3NvdXJjZT1ndW10cmVl&jid=782239&xid=4283259457
4h
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