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 Benefits
• To follow up on behalf of members on all outstanding claim payments
• To deal with member queries and advise members on fund benefit structure and benefits
• To act as a liaison between the members of the Fund and Funds other service providers (funeral benefit administrator, Section 37C Investigators, Trust Fund Administrators, Tracers) in receiving claims and ensuring that they are processed timeously.
• To assist in employer engagements in areas where they are visiting

Areas of Responsibilities

Key Activities

Member Walk-Ins

• 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 available:
    • Claim documents are completed and signed and stamped by both employer and member
    • Copy of ID is available and clear
    • Copy of bank statement is available and clear
    • Letter from SARS is available and show Tax number
  • Advise member is there are any discrepancies regarding the membership or any of the above.
  • Help member to understand what the member needs to do.
• 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 and/Compliance Manager for further investigation.
• Provide members with benefit statements, where available.
• Help member submit the funeral claims to the funeral claim administrator.
• Educate members on benefits of the fund and process.
• Provide a weekly report to the manager for consideration and review.

Planning for Travelling

• Complete a yearly travel plan split per month
• All travel plans to be approved by the manager and ultimately by the head of department before you embark on a trip. All travel requirements to be fulfilled prior to submission for approval.
• Any deviation from plan must be motivated and plans changed accordingly.

Assisting with Employer Engagements

• To inform all Client Liaison Officers (CLOs) of planned pending trips and to get a list of employers that needed to be visited from CLOs
• To prepare for employer visits by ensuring that a full recon, outstanding claims and unallocated contributions have been obtained
• To check with the Agents that the employers to be visited have been registered with the NBC and if not to include in the preparation for the visits
• To escalate all matters arising from the employer meetings/visits to the relevant departments and ensure that they are acted on

Reporting and Admin

• Submit daily and weekly reports including any ad-hoc reports as and when required by business
• All claims and documents to be uploaded and indexed on Everest/EPIC system used by Salt
• To provide reports after every employer visits with challenges and actions required. The report will be provided the following day after coming back from the visit

Relationship Management

• Attend to requests from other stakeholders like Member Unions, Employer Unions and PSIRA as and when the requests come in
• 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

1. No quality assurance failures on new claims submitted
2. Feedback from members, colleagues and employers on employee performance
3. All claims initiated on EPIC will have complete documents and ready for processing
4. Unpaid claims outside of SLA timeframes that have been escalated for payments
5. Unattended claims with proof of escalations
6. Identified discrepancies between work done by yourself and your colleagues.
7. Members assisted are correctly captured and reported.
8. Timeous reports on employer engagements.
9. Reports provided daily without any errors.

Competencies required:

• Matric
• Basic Excel skills
• Code 10 drivers license with PDP
• 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

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