Claims Administrator

Salt Employee Benefits; Midrand; On-site; ZAR 300 000 - 400 000; Full time

Job summary

A financial services firm in Midrand is looking for a Claims Administrator responsible for processing claims accurately and handling inquiries. The candidate should have at least 2 years of experience in employee benefits, knowledge of pension fund legislation, and strong communication skills. The role demands excellent time management and the ability to work under pressure. Competitive salary and benefits are included in this full-time position.

Qualifications

• At least 2 years experience in employee benefits or retirement fund administration.
• Solid knowledge of pension fund legislation (Sections 13A, 37D, and 37C).
• Ability to manage high claim volumes and work under pressure.

Responsibilities

• Process claims accurately within the service level agreement.
• Attend to email and telephonic enquiries.
• Maintain accurate records and filing of claims.

Skills

Employee benefits / retirement fund administration

Communication (Written and Verbal)

Time management

Customer service

Attention to detail

Education

Matric

Undergraduate degree/Retirement Fund qualification

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

The claims administrator is responsible for accurate processing of claims, within the agreed service level agreement between SALTEB and the fund and meeting production standards. Duties include requesting information and responding to enquiries, ensuring quality assurance on documents and assessing claim legitimacy. Key responsibilities include initiating new claims, following up on outstanding payments, addressing member queries, providing guidance on fund benefits, and coordinating with service providers to ensure timely claim processing.

Key Responsibilities

• Ensure all quality assurance related activities as set out in the Quality Assurance checklist have been actioned.
• If quality assurance is required, complete quality assurance process as set out in the Quality Assurance checklist.
• Calculate the benefit.
• Apply for a tax directive.
• Prepare the payment requisition.
• Ensure the bank details have been accurately captured onto the member's record and verified by the bank.
• Attach all relevant documentation, collate in required format and submit for quality assessment.
• All claim related activities which include the complete claim processing cycle of all claims, claim related enquiries and complaints, must be completed in accordance with the rules and policies of the Fund, legislation, administration procedures and within the service level agreement applicable to the Fund.
• Meet production standards in terms of quantity (process 40 claims per day (2.5% error rate).
• Should a query arise at any point, complete investigation and delegate to responsible party to resolve. Member notes to be updated accordingly.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
• Ensure email communication, whether internal or external are dealt with professionally and within the service level agreement.
• Any other duties as determined by the business needs and participate in all organisational events as required.

Query Resolution

• Attend to all email and internal and external telephonic enquiries.
• Assist the consultants and call center to resolve queries.

Record Keeping and Filing

• Attach all email correspondence to the member's record.
• Assist the consultants and Call Centre resolve.

Relationship Management

• Strictly adhere to the rules and policies of the Fund, legislation, administration procedures and service level agreements.
• Build and maintain relationships at all levels with service providers and internal departments to enhance organisational effectiveness and efficiency.
• Use your best endeavours to properly conduct, improve, extend, develop, promote, protect and preserve the business, reputation and goodwill of the company.

Time Management

• Excellent time management.
• Ability to manage high claim volumes
• Flexible and ability to work under pressure and multitask.

Essential Knowledge and Skills

• At least 2 years employee benefits / retirement fund administration experience specifically in a similar role processing and paying retirement fund claims.
• A solid knowledge of pension fund legislation (specifically Sections 13A, 37D and 37C), regulations and guidelines.
• Everest experience will be advantageous.
• Knowledge and understanding of unitisation.
• Good knowledge of Microsoft Outlook, Word and basic Excel skills.
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• Communication (Written and Verbal).
• English (Business writing and email etiquette).
• A self-starter who can work independently with minimal support but who can also work in a team environment.
• Accuracy and attention to detail.
• Judgement and Decision Making.
• Working under pressure And Deadline driven.
• Organizational skills / Planning and prioritizing.
• Interpersonal skills.
• Cross team collaboration.
• Innovation.
• Customer service.
• Knowledge of two pot system.

Qualification Requirements

• Matric.
• Good command of English.
• Undergraduate degree/ Retirement Fund qualification (Advantageous).
• FICA Awareness Training.