Metropolitan Retail - Admin vacancy

INTRODUCTION

An exciting opportunity awaits a performance driven and client focused individual, to undertake an exciting Ex Gratia Administration role in a highly deadline orientated environment.

REQUIREMENTS

Matric and relevant tertiary qualification will be an advantage
At least 5 years' experience in Medical Aid Industry
Extensive computer experience on Ms Word and Outlook
Extensive experience in the loading of filters and processing of claims

THE WORK YOU NEED TO DELIVER

Perform administrative duties and provide a professional service to GEMS where special grants are requested in cases where medical. expenditure, in excess of the Scheme's limits, has caused and or would cause financial hardship for members.
Using your expertise and experience, make a decisions on whether the application received qualifies for Ex-gratia consideration.
Process all documentation received from members, service providers , Managed Care Service provider and the Principal Officer accurately and timeously and at all times maintain confidentiality.
Apply Scheme rules and mandates on re-processing of Ex-gratia applications.
Make a decision to reject some Ex-gratia applications as per the mandate guideline and SOP where appropriate.
Accurately prepare Ex-gratia cases for presentation by the Ex-gratia manager to the Ex-gratia Committee, comprising of the Scheme's Board of Trustees at the Scheme offices.
Provide and maintain accurate and thorough telephonic information to members, service provider and Business Partners ( MHRS) regarding queries for claims, membership, finance, and general client services relating to Ex-gratia.
Accurately review, investigate and reprocess member accounts, where necessary, during preparation of the Ex- gratia application, before the Ex-gratia meeting.
Accurately reprocess all accounts approved by the Scheme Board of Trustees after the Ex-gratia meeting.
Establish and maintain knowledge of Ex-gratia Guidelines, Scheme Rules , Benefit Exclusions and Claims operational systems for GEMS.


COMPETENCIES REQUIRED

Excellent communication skills (written and verbal)
Detail orientation
Client service orientation
Excellent planning and organising skills
Ability to work in a team

ADDITIONAL INFORMATION

Shortlisted candidates will be subjected to the following statutory checks:
References
ITC
Qualification
Criminal

How to apply for this:

APPLY HERE

Closing date: 07-12-2017