Medical Aid Service coordinator – Senior (Medical Aid) – KZN Durban

 

Recruiter:

Execuplace Appointments

Job Ref:

Medical Aid Service ..

Date posted:

Thursday, February 10, 2022

Location:

Durban, South Africa

Salary:

R336 000


SUMMARY:
Our client being a Financial Services provider is looking for Service coordinator – Senior (Medical Aid) - KZN

JOB DESCRIPTION:

ESSENTIAL FUNCTIONS

  • Loading/checking/updating cases on internal client relationship systems (DCP and BIAS), including new activations and terminations, queries and underwriting
  • Flexi care activations each month
  • Submit Terminations each week and month
  • Ensure that all membership movements are implemented on the monthly billing
  • Respond to member queries where necessary
  • Work through induction packs each month and identify member applications for medical aid
  • Submitting medical aid applications to the schemes and follow ups
  • Cross check terminations with activations each week and month
  • Assist with provident fund withdrawal claims, ensuring all documentation is complete prior to submission for Admin Department – main claims processing function being done in JHB office
  • Following up regularly on the progress of the claim in accordance to provider timelines
  • If there is outstanding information from client HR/member, follow up on a regular basis until the documentation is received and submitted to the provider
  • Delays on claims to be escalated to managed
  • Full understanding of the clients benefits and rates per provider
  • Special projects

 

EXPERIENCE REQUIRED

  • Minimum 3 to 5 years’ experience in medical scheme membership administration
  • Proficient in advanced Excel, Outlook, internal systems and team expectations
  • Knowledge of employee benefits structures (Pension, Provident, Life cover Disability Benefits), FICA, FAIS and TCF – a bonus to have
  • Full understanding of medical aids and employee benefits, requirements, timelines, and processes

 

WORK ENVIRONMENT

Business Support - Performs a professional specialised support function in office and at client sites, including clerical / administrative support.  May require vocational training or the equivalent experience.

Category 3:  Has working knowledge and skills developed through formal training or work experience.  Works within established procedures with a moderate degree of supervision.  Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures and makes sound decisions

 

Essential Qualifications:

  • 3 to 5 years medical aid experience – either in Medical Aid Administrator or with an FSP – with relevant training certificates

 

Preferred Qualifications:

  • 3 to 5 years medical aid experience
  • NQF Level 5 RE
  • FAIS

 

NB! This job is now closed. You can apply for other jobs by uploading your CV.


 

 

 

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