Role OverviewThe role involves ensuring quality assurance on documents and assessing claim legitimacy. Key responsibilities include initiating new claims, following up on outstanding payments, addressing member queries, providing guidance on fund benefits, and coordinating with service providers to ensure timely claim processing.
Key ResponsibilitiesWalk-in members
Receive members and help them with submission of claim. First ensure that the member is a member of the Fund Ensure that the member is not still employed in the industry Check that the contributions are up to date
Check that all claim documents are availableClaim documents are completed, signed and stamped by both employer and member Copy of ID is available and clear Copy of bank statement is available and clear Valid 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 member of any outstanding documentation or what will affect the delay of the claim. Advise members who come to enquire about their membership on their status Where 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 management. Flexible and ability to work under pressure and multitask.
KPI's
No quality assurance failures on new claims submitted. Feedback from members, colleagues and employers on employee performance. All claims initiated on EPIC will have complete documents and ready for processing. Unpaid claims outside of SLA timeframes that have been escalated for payments. Unattended claims with proof of escalations. Identified discrepancies between work done by yourself and your colleagues. Members assisted are correctly captured and reported. Timeous reports on employer engagements. Reports provided daily without any errors.
Essential Knowledge and Skills
Basic Excel skills Communication (Written and Verbal) English (Business writing and email etiquette) Stakeholder management (CRM) Industry knowledge and at least 2 years Industry experience Accuracy and attention to detail Judgement and Decision Making Working under pressure And Deadline driven Organizational skills / Planning and prioritizing Interpersonal skills Settings goals Cross team collaboration Innovation Management of time Customer service
Qualification Requirements
Matric Undergraduate degree/ Retirement Fund qualification (Advantageous) Retirement Fund/Employee Benefits industry experience
How To Apply
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Make sure you are logged in and your email is verified(Register if you dont have an account).
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Click the Apply Now button above.
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Your default email application or application link will open.
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Attach your Application letter, updated Curriculum Vitae (CV) and any supporting documents required.
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Use a professional subject line such as Application for "Indicate Positions"
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Send your application before the closing date.
Note: Only shortlisted candidates are contacted.
