ROLE

The Claims Administrator is responsible for the accurate and timeous processing of death claims within the agreed service level between SALT EB and the Fund and meeting production standards.

The duties include processing claim payments, requesting information, responding to queries and assisting Client Services, the Call Centre, the Contributions team, Claims team, employers and external service providers.

KEY ACTIVITIES

• Perform all death claims related activities which include – claim processing, responding to claims related queries and complaints.
• Application of fund rules, policies, legislation, administration procedures and the service level agreement when processing
• Meet production standards in terms of quantity and quality.
• Liaise with employers and service providers.
• Attend to the fund central mailbox and respond to queries within SLA.
• Any other duties as determined by business needs and participate in all organizational events as required.

RECORD KEEPING AND FILING

• Attach all email correspondence to the member’s record.
• Record all appropriate member notes on member’s Everest record.
• Ensure the bank details are accurately captured onto the member’s record and verified by the bank.
• Print all relevant documentation, collate in required format and submit for quality assessment.

QUERY RESOLUTION

• Attend to all email and telephonic queries.
• Assist Client Services, the Call Centre, the Contributions team, Claims team, employers and external service providers to resolve queries.
• Follow through and provide client with on-going feedback until query is resolved.
• Support a positive and responsive climate for client query resolution.
• Verify member statement and exit audit report for accuracy. Ensure the automated switch out of investment into bank was processed and the total number of units is zero.
• Apply for a tax directive on the calculated benefit.
• Apply the correct dates for calculations and benefit accrual.
• Prepare the payment requisition.
• Perform all claim related activities which include claim processing cycle, attending to queries and complaints.
• Communicate with beneficiary fund administrators and provide relevant information within SLA
• Correct application of the fund rules, policies, legislation, administration procedures and the service level agreement applicable to the fund.
• Meet production standards in terms of quantity (process 40 claims per day) and quality (less than 2.5% error rate).

TEAM SUPPORT

• Accept accountability and take responsibility for any work done or allocated.
• Display a willing and helpful attitude.
• Carry out any other duty as allocated by the manager.
• Abide by audit findings as directed by Claims Team Leader.
• Attend internal and external training as required.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties.
• Use your best endeavors to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company.
• Support a positive and responsive climate for client query resolution.
• Accept accountability and take responsibility for tasks done.

RELATIONSHIP MANAGEMENT

• Build and maintain relationships at all levels with service providers and internal departments to enhance organizational effectiveness and efficiency.
• Use your best endeavors to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company
• Build and maintain relationships at all levels with internal departments to enhance organizational effectiveness and efficiency.
• Ensure email communication, whether internal or external are dealt with professionally and within the agreed service level agreements.

TIME MANAGEMENT

• Excellent time management.
• Action all escalated enquiries within 24 – 72 hours.
• Must be available to work overtime when the need arises.
• Flexible and ability to work under pressure and multitask.

EDUCATION & QUALIFICATION

• Matric certificate with maths.
• Can communicate in official SA official languages.
• Communicates well in common business language/s.
• Death claims process.
• FICA awareness training.

ESSENTIAL KNOWLEDGE, SKILLS AND EXPERIENCE

• Thorough knowledge of Section 37C of Pension Fund Act
• A solid knowledge of related legislation, (e.g. Income Tax Act),
• Understand claims process, 4+ years experience
• MS Excel intermediate level, use formulas and macros
• MS Outlook experience, use of reminder, calendar, create subfolders
• Understanding the reporting process claims area,
• Prepare and clean data for reporting
• Minimum 2 years employee benefits administration experience
• Experience in handling administration queries
• Good verbal and written communication skills
• Everest experience will be advantageous.
• Excellent numerical skills.
• Methodical and meticulous.
• A self-starter who can work independently with minimal support but who can also work in a team environment.

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