Medical Aid administrator \ Services Co-ordinator Cape Town

SERVICE COORDINATOR Cape Town

Division

Position Job title

Business area

Cape Town – Employee Benefits Company

Closing date

Date

Salary grade/level/family/range— including minimum and maximum pay bands.

R24 348

Type of role:

Permanent

Position type and expected hours of work

FULL TIME – 5DAYS PER WEEK – 8H00 TILL 17H00

Position Location

CAPE TOWN

Qualification Essential Competency

Essential Qualifications:

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

Qualification preferred education and experience

Preferred Qualifications:

-      3 to 5 years medical aid experience

-      NQF Level 5 RE

FAIS

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.

Physical demands

Travel

Yes