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Position: Ex Gratia Administrator
Closing Date: 16 November 2024
Reference Number: MMH240910-8
Type: Permanent
Role Family: Client Services
Cluster: Health Solutions
Location: Bellville, Western Cape, South Africa
Remote Opportunity: Partially remote available
Introduction
Momentum Metropolitan provides financial solutions through brands like Metropolitan, Momentum, and Multiply (a wellness and rewards program). The group also includes Guardrisk and Eris Property Group. It serves individuals, businesses, and communities, helping them save, invest, and protect what matters most. The company’s network of advisers and brokers ensures practical financial solutions for diverse needs. More information is available on the Momentum Metropolitan website.
Disclaimer:
Please verify the legitimacy of this job advert on the company's career page.
Role Purpose
The Ex Gratia Administrator is responsible for preparing and managing cases to be reviewed by the Client's Ex Gratia Committee Board members.
Minimum Requirements
Education:
- Grade 12 (Matric) or equivalent qualification
- Relevant Degree or Diploma in a clinical field (advantageous)
Experience:
- 2-3 years of experience in the medical aid industry
- 2-3 years of client service experience
- Basic knowledge of claims processing and filters
- Extensive experience with Microsoft Word and Outlook
Key Duties & Responsibilities
Internal Processes:
- Perform administrative duties related to special grant requests from members.
- Maintain up-to-date knowledge of Ex Gratia Guidelines, Scheme Rules, Benefit Exclusions, and Claims systems.
- Accurately process documentation from members, service providers, Managed Care Service providers, and Scheme officials.
- Prepare Ex Gratia cases for the Ex Gratia Manager to present to the Ex Gratia Committee, including Scheme Board of Trustees and officials.
- Provide detailed, confidential telephonic information to members, service providers, and Business Partners.
- Communicate meeting outcomes to members and draft outcome letters.
Client Services:
- Build and maintain strong relationships with clients and stakeholders.
- Meet service level agreements to ensure client expectations are managed effectively.
- Suggest improvements for client service and fair treatment within the role’s scope.
- Monitor turnaround times and quality standards, promptly resolving issues to enhance client service.
- Handle client queries, track their resolution, and use feedback to refine business processes.
People and Team Development:
- Foster strong relationships by sharing specialist knowledge and leadership.
- Continuously enhance personal expertise in industry-related matters.
- Positively influence change management, offering specialist support when needed.
- Contribute to innovation by sharing new ideas and collaborating with colleagues.
- Take responsibility for career development and encourage a productive, client-focused work culture.
Financial Management:
- Assist in budget planning to minimize expenditure and align with operational goals.
- Propose solutions to enhance cost-effectiveness and efficiency.
- Participate in governance processes and ensure compliance with relevant legislation.
- Escalate unresolved policy and compliance issues for investigation and resolution.
- Provide input on risk identification and communicate recommendations effectively.
Competencies
- Business Acumen: Understands financial and industry matters relevant to the role.
- Relationship Building: Establishes and maintains strong professional relationships.
- Sense of Urgency: Acts with speed, accountability, and agility.
- Change Management: Positively influences and manages change.
- Communication: Persuades, influences, and inspires others effectively.
- Self-Management: Demonstrates good self-awareness and relationship management.
- Inclusivity: Promotes a culture of inclusivity and humility.
For further details or to apply, visit the Momentum Metropolitan career page. If you do not receive a response within 28 days after the closing date, please consider your application unsuccessful
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