Benefits Administrator

SUMMARY:
The Role:

Essential functions:

• Quality assure all claim forms received and capture the task on the CRM system
• Submitting the completed claim form plus supporting documentation to the provider 
• Following up regularly on the progress of the claim in ...
  
  

  POSITION INFO:
  The Role:

  Essential functions:

  • Quality assure all claim forms received and capture the task on the CRM system
  • Submitting the completed claim form plus supporting documentation to the provider 
  • Following up regularly on the progress of the claim in accordance to provider timelines 
  • If there are outstanding information from HR/member, the administrator must follow up on a regular basis until the documentation is received and submit to the provider 
  • Updating/saving all correspondence between the member/provider/employer on the CRM system
  • Ensure that all membership movements are implemented on the monthly billing
  • Delays on claims to be escalated to managed
  • Full understanding of the clients benefits and rates per provider
  • Special projects
  Skills and Experience:

  Essential Qualifications:

  • NQF Level 5
  • RE FAIS

  Experience required:

  • Minimum 5 yearsâ?? experience in medical scheme membership administration 
  • Proficient in advanced Excel
  • Advanced knowledge on employee benefits rules, FICA, FAIS and TCF
  • Advanced knowledge of employee benefits processes
  
  
  

   

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