Claims Administrator

Salt Employee Benefits; Gauteng; On-site; ZAR 180,000 - 240,000; Full time

Job summary

Salt EB is seeking a meticulous Claims Administrator for our PSSPF Claims team in Gauteng. You will ensure claims and documents meet standards, support quality assurance and data accuracy, and help resolve client queries to minimise financial risk.

The role focuses on processing readiness, documentation completeness, and collaboration with Front Office and Compliance to uphold service levels and governance.

Qualifications

• Matric/Grade 12 or equivalent.
• Proficient in Microsoft Excel.
• Excellent written and verbal communication in business English.
• Industry knowledge in claims administration or employee benefits.
• Ability to verify information accurately and resolve queries.
• Strong organizational and multitasking skills.

Responsibilities

• Perform quality assurance on claims and related documents.
• Verify claim checklists and forms are complete and signed.
• Ensure data on Everest matches system information and resolve discrepancies.
• Maintain accurate member records and bank details.
• Respond to queries from internal teams and clients within SLA.
• Assist with obtaining outstanding requirements for claims as needed.
• Support team with process improvements and documentation.

Skills

Microsoft Excel

Written and verbal communication

Attention to detail

Teamwork

Education

Matric (Grade 12) or equivalent

Tools

Everest System

Job description

Overview:

Salt EB is seeking a meticulous, team player and service-driven Claims Administrator to join our PSSPF Claims team. The successful candidate will be responsibl for efficient administration and verification service in respect of quality assurance of claims that results in the improvement of client service and to minimise financial risk. The main responsibility of the Claims Administrator is to ensure that all claims and related documents conform to the set standards, within the agreed service levels and that the claim is ready for processing by the claim administrator.

Key Responsibilities:

• Perform all quality assurance related activities as set out in the Quality Assurance checklist, which may change from time to time and which include all email, in-person and outbound telephonic enquiries / queries.
• Verify that the Fund’s claim checklist is fully completed and signed by an authorised representative.
• Ensure that the claim form is fully completed and signed by the relevant parties.
• Verify that the claim form reflects information that coincides with the data on Everest (System) and where there is a variance or difference, or any other query, return the
• claim documents to the Front Office colleagues.
• Ensure that all mandatory documents are received.
• Determine whether there is an outstanding housing loan and or indebtedness for the member (i.t.o. Section 19 (5) (a) or Section 37D (b) (ii) of the Act) or note on Everest
• for loans.
• To complete due diligence by ensuring that the following match the system information: (Corrections to be sent to TSRF Data mailbox for verification and correction where applicable), example, name, surname, identity number and date of birth.
• Complete member static data member / employer physical address, member tax number, member / beneficiary bank details.
• Member / beneficiary bank account holder verification to be done after loading Workflow.
• Investigate whether the member has a record on the Unclaimed Benefit Fund
• Assist the Contact Centre when required by providing information and resolving queries.
• Assist the claim administrator by obtaining outstanding requirements on claims as requested by the claim administrator (due to quality assurance fail).
• Strict adherence to the rules and policies of the Funds, legislation, administration procedures and service level agreements.
• The QA administrator will attend internal and external training as required.
• Meet production standards in terms of quantity (40 cases per day) and quality (less than 1% error rate).
• Accept accountability and take responsibility for tasks.
• Build and maintain relationships at all levels with internal departments to enhance organisational effectiveness and efficiency.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
• Use your best endeavours to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company.
• Any other duties as determined by the business needs and participate in all organisational events as required, e.g. projects.
• Work overtime as determined by the business needs and in terms of the company policy.

Record Keeping and Filing:

• Maintain accurate and complete records on the Everest system.
• Ensure all correspondence is properly attached to member/deceased member files.
• Capture accurate member notes and updates on the system.

Query resolution:

• Respond to internal and external email and telephonic queries efficiently and professionally.
• Liaise with Client Services, Contact Centre, Compliance, employers, and service providers to resolve queries.
• Provide continuous feedback until queries are fully resolved.
• Attend to escalations within 24–48 hours.
• Support Contact Centre, Compliance and Claims Administrators with information and documentation requests.

Team Support:

• Accept accountability and take responsibility for any work done or allocated.
• Display a willing and helpful attitude.
• Action any other responsibilities allocated by the team leader / head of.

Relationship Management:

• Build and maintain strong working relationships across internal departments and external stakeholders.
• Promote a professional, responsive, and client-centric service culture.
• Uphold the company’s reputation, values, and service standards at all times

Required Experience and Competencies:

• Matric (Grade 12) or equivalent qualification.
• Proficient in Microsoft Excel.
• Excellent written and verbal communication skills, with proficiency in business English, professional email correspondence and email etiquette.
• Industry Knowledge. Relevant knowledge and experience within the claims administration or employee benefits industry.
• Ability to process and verify information accurately.
• Ability to assess information, make informed decisions and resolve administrative queries effectively.
• Ability to manage workloads, meet deadlines and maintain accuracy
• Strong ability to organise, prioritise and manage multiple tasks efficiently.
• Ability to set clear objectives, take ownership of responsibilities.
• Ability to work effectively with different teams and departments.
• Ability to identify opportunities for process improvements and contribute practical solutions.