The purpose of this position is to provide efficient administration and verification service in respect of quality assurance of claims that results in the improvement of client service and to minimise financial risk. The main responsibility of the Quality Assurance Administrator 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 by the claim administrator. Perform quality assurance based on the specialized requirements of the role.

Areas of

• Perform all quality assurance related activities as set out in the Quality Assurance checklist, which may change from time to time and which include all email, interpersonal and outbound telephonic enquiries / queries.
• Verify that the claim form reflects information that coincides with the data on Everest (System) and where there is a variance or difference, or any other query, return the claim documents to the Front Office colleagues.
• Ensure that all mandatory documents are received.
• Determine whether there is an outstanding housing loan and or indebtedness for the member (i.t.o. Section 19 (5) (a) or Section 37D (b) (ii) of the Act) or note on Everest for loans.

• Complete member static data member / employer physical address, member tax number, member / beneficiary bank details.

• Member / beneficiary bank account holder verification to be done after loading Workflow.

  • Create a Workflow within 24 hours of receipt of funeral / death / disability / unclaimed benefit and within 72 hours of receipt of other exit documentation.
  • Investigate whether the member has a record on the Unclaimed Benefit Fund
  • Assist the Contact Centre when required by providing information and resolving queries.
  • Assist the claim administrator by obtaining outstanding requirements on claims as requested by the claim administrator (due to quality assurance fail).
  • Strict adherence to the rules and policies of the Funds, legislation, administration procedures and service level agreements.
  • The QA administrator will attend internal and external training as required.
  • Meet production standards in terms of quantity (50 cases per day) and quality (less than 1% error rate).
  • Accept accountability and take responsibility for tasks.
  • Build and maintain relationships at all levels with internal departments to enhance organisational effectiveness and efficiency.
  • Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
  • Use your best endeavours to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company.
  • Any other duties as determined by the business needs and participate in all organisational events as required, e.g. projects.
  • Work overtime as determined by the business needs and in terms of the company policy.

    Required Knowledge:

• Should be able to ensure strong stake holder management ito Communication i.e. feedback to clients, managing clients, responding to clients, attend to queries timeously
• Engage in a professional manner whether it be verbal or face to face
• Have the ability to communicate via different communication channels in order to resolve risks/challenges raised from the QA
• Ensure 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 player
• Have both industry knowledge and experience
• Ensure 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 role
• Ensure 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 role through the various risks / assurance issues picked up and to suggest ways to limit these occurrences from happening again.
• Quality of work should be thorough

Administrator Quality Assurance position available in Gauteng, Johannesburg. This job position was posted by Salt Employee Benefits. The job has been posted as a premium ad on 2025-02-07 at 13:30:01 in the Finance Accounting category