Portfolio Administrator - Employee Benefits (Group Risk)

Purpose of the Job

• Responsible for the reconciliation of the monthly membership data vs. premiums due and received. Responsible for initial update in respect of client reconciliation
• Responsible for the submission of all risk benefit claims received and monitoring the process until claims are paid

Key Relationships

• External Insurance Companies / Underwriter Consultants
• Internal and External Brokers
• Internal Staff

Key Responsibilities

Data:

• On a monthly basis ensure premiums and data are received for each scheme
• Ensure the correct updating of the scheme membership data
• Reconcile the monthly membership data (as updated) vs premiums received per scheme
• Ensure strict adherence to the documented processes
• Update membership onto relevant administration platform and ensure this balances to the client

premium reconciliation and data Reconciliations:

• Prepare and provide premium recons to clients monthly analysing under or over payments
• Perform credit control checks and follow up for over and underpayments
• Follow PPR15 processes by informing clients of non-payment within specified deadline Claims:
• Action all claims timeously
• Ensure correct execution of all claims in terms of documented processes
• Maintain updated claims workflow systems
• Ensure data records are always correct with regards to PHI claimants Medicals
• On a monthly basis identify members whose insured benefits are in excess of the Medical Free Cover Limit on each scheme
• Process medical requests immediately in terms of set guidelines
• Ensure data records are always correct with regards to members whose insured benefits are in excess of the Medical Free Cover Limit on each scheme
• Maintain updated medicals workflow system

General

• Attend to all other client requests (benefit statements, conversion options, monthly billings etc.)
• Ensure the divisional renewals team is provided with information required to do the annual renewals on the schemes
• Assist (as and when required) the divisional finance team to ensure that the client reconciliations of premiums due and received are updated correctly

Education/Qualification requirements

• Matric
• Relevant business qualification or equivalent experience
• At least 3 years of relevant working experience

Skills and Knowledge requirements

Skills

• Highly Computer literate and thorough knowledge of Excel and its application
• Analytically Inclined
• Accounting Inclined
• Strong Administrative skills
• Problem solving ability
• Good Communication skills
• Professional Independence and assertiveness

Knowledge

• Thorough knowledge of Risk Benefits & Employee Benefit Industry
• Extensive work experience and knowledge linked to the Risk Benefit Industry
• Understanding of the Financial Services Industry

Key Attributes

• Integrity: Being ethical and truthful, maintaining good governance practices, and not misrepresenting or withholding information to which stakeholders are entitled.
• Interdependence: The achievement of goals is based on the interrelationship of all the components of the service delivery chain.
• Client focus: Actions derived from stakeholder needs.
• Organisational Awareness: Understands business plan goals.
• Teamwork: Working cooperatively and productively with others to achieve results
• Impact and Influence: Persuading, convincing or influencing.
• Fairness: Consistency in dealing with others
• Professional Work Ethic: Always working with diligence, competence, confidentiality, and reliability.  Self-managed: able to work without constant supervision