Talent Pool | MSOI Administrator

Discovery Limited; Sandton; On-site; ZAR 111,600 - 167,400; Full time

Job summary

Discovery Health in Africa is seeking candidates to support the Africa Health Hub with processing of client claims, from review of data to submission on the client portal.

The role involves capturing claims, acknowledging receipt, preparing communications, and handling inquiries from providers, members and brokers while ensuring accuracy and compliance. Administrative support for claims management and reporting is also required.

Responsibilities

• Accurately capture and record all professional and general liability claims within prescribed service standards.
• Acknowledge and confirm receipt of all claims.
• Prepare and distribute claim-related communications to members, healthcare providers, and stakeholders.
• Manage inquiries from providers, members, brokers regarding claim status and updates.
• Maintain complete records of claim correspondence for audit readiness.
• Liaise with internal and external stakeholders to facilitate processing and resolution of claims.
• Provide timely customer service while upholding policies and service standards.
• Assist with administrative functions related to claims management and reporting.

Job description

Discovery Health | Africa Health Hub

Medical Services Organisation | Administrator

About The Discovery Africa Team

Discovery Africa is a subsidiary of Discovery Health and strategically extends Discovery’s reach through delivery in key business activities: Provision of Health insurance products underpinned by Vitality and Shared value principles, targeting growth across the African continent. Products are currently sold in: DRC, Mozambique, Kenya, Zambia, Ghana, Nigeria and Tanzania. Third Party Administration services provided to global, multi-national insurance organisations. Coverage extends to all countries on the African continent (except CAR and Guinea Bissau). 24/7 Medical assistance to inbound travellers to South Africa and outbound travellers to the rest of the world. This includes Discovery Health members covered under the international travel benefit (ITB).

Key Purpose

The role involves the provision of admin assistance in processing of client claims from review of data to the submission on the client portal.

Duties And Responsibilities

• Accurately capture and record all professional and general liability claims received through various advocacy and reporting platforms, ensuring complete and compliant documentation.
• Acknowledge and confirm receipt of all claims within the prescribed service standards.
• Prepare and distribute claim-related communications to members, healthcare providers, and other relevant stakeholders.
• Manage and respond to telephonic, email, and written enquiries from providers, members, brokers, and other stakeholders regarding claim status, updates, and general claim-related matters.
• Maintain accurate records of all claim correspondence and interactions to ensure effective tracking and audit readiness.
• Liaise with internal and external stakeholders to facilitate the efficient processing and resolution of claims.
• Provide timely and professional customer service while ensuring adherence to company policies, procedures, and service level agreements.
• Assist with administrative functions related to claims management and reporting as required.

Outputs

• Accurate and timely capturing of all professional and general liability claims.
• Prompt acknowledgement and confirmation of claim receipt.
• Effective communication with members, providers, brokers, and other stakeholders.
• Timely resolution and follow-up of claims-related enquiries.
• Maintenance of complete, accurate, and up-to-date claims records.
• Consistent delivery of high-quality administrative support to the claims function.
• Compliance with company procedures, regulatory requirements, and service standards.

Competencies

• Claims processes and procedures
• Insurance principles
• Relevant legislation and regulations
• Company systems and software
• Communication protocols
• Finance principles
• Data capturing and records management
• Applying claims processes and procedures
• Using company systems and software effectively
• Communicating according to established protocols
• Maintaining accurate records and documentation
• Attention to detail
• Professionalism and ethical conduct
• Customer focus
• Confidentiality and integrity
• Accountability and reliability
• Compliance-oriented mindset

Education And Experience

Education:

• Matric
• Administration qualification advantageous

Experience:

• 1 year administrative experience
• Basic MS Office knowledge and experience

Personal Attributes or Competency Profile

• Values Driven
• Optimistic
• Learns on the Fly
• Resilient
• Instils Trust
• People Savvy
• Drives Results
• Problem Solver

Employment Equity

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.