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