Service Coordinator (Cape Town)

JOB SUMMARY:
The Role:

Responsibilities:

• 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 ...
  
  

  JOB DESCRIPTION:
  

  The Role:

  Responsibilities:

  • 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 â?? 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

  Skills and Experience:

  Essential Qualifications:

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

  Preferred Qualifications:

  • 3 to 5 years medical aid experience
  • NQF Level 5 REFAIS

  Experience required:

  • Minimum 3 to 5 yearsâ?? 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 â?? a bonus to have
  • Full understanding of medical aids and employee benefits, requirements, timelines, and processes

  Other:

  Work environment:

  • Business Support - Performs a professional specialised support function in office and at client sites, including clerical / administrative support. 
  • Works within established procedures. Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures and makes sound decisions.

   

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