ROLE OVERVIEW The claims administrator is responsible for the accurate processing of claims, within the agreed service level agreement between SALTEB and the fund and meeting production standard. The duties include requesting information and responding to enquiries, 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 Responsibilities Ensure all quality assurance related activities as set out in the Quality Assurance checklist have been actioned. If quality assurance is required, complete quality assurance process as set out in the Quality Assurance checklist. Calculate the benefit. Apply for a tax directive. Prepare the payment requisition. Ensure the bank details have been accurately captured onto the member’s record and verified by the bank. Attach all relevant documentation, collate in required format and submit for quality assessment. All claim related activities which include the complete claim processing cycle of all claims, claim related enquiries and complaints, must be completed in accordance with the rules and policies of the Fund, legislation, administration procedures and within the service level agreement applicable to the Fund. Meet production standards in terms of quantity (process 40 claims per day (2.5% error rate). Should a query arise at any point, complete investigation and delegate to responsible party to resolve. Member notes to be updated accordingly. Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy. Ensure email communication, whether internal or external are dealt with professionally and within the service level agreement. Any other duties as determined by the business needs and participate in all organisational events as required. Query Resolution Attend to all email and internal and external telephonic enquiries. Assist the consultants and call center to resolve queries. Record Keeping and Filing Attach all email correspondence to the member’s record. Assist the consultants and Call Centre to resolve queries. Relationship Management Strictly adhere to the rules and policies of the Fund, legislation, administration procedures and service level agreements. Build and maintain relationships at all levels with service providers and internal departments to enhance organisational effectiveness and efficiency. Use your best endeavours to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company. Time Management Excellent time management. Ability to manage high claim volumes Flexible and ability to work under pressure and multitask. Essential Knowledge and skills At least 2 years employee benefits / retirement fund administration experience specifically in a similar role processing and paying retirement fund claims. A solid knowledge of pension fund legislation (specifically Sections 13A, 37D and 37C), regulations and guidelines. Everest experience will be advantageous Knowledge and understanding of unitisation Good knowledge of Microsoft Outlook, Word and basic Excel skills Communication (Written and Verbal) English (Business writing and email etiquette) A self-starter who can work independently with minimal support but who can also work in a team environment Accuracy and attention to detail Judgement and Decision Making Working under pressure And Deadline driven Organizational skills / Planning and prioritizing Interpersonal skills Cross team collaboration Innovation Customer service Knowledge of two pot system Qualification requirements Matric Good command of English Undergraduate degree/ Retirement Fund qualification (Advantageous) FICA Awareness Training
