Technical Claims Administrator

icon building Company : Pps
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Job Description - Technical Claims Administrator

PPS has more than 200 000 members who enjoy access to a comprehensive suite of financial and healthcare products that are specifically tailored to meet the needs of graduate professionals. PPS is the largest South African company of its kind that still embraces an ethos of mutuality, which means that it exists solely for the benefit of its members. Thus, members who are policyholders can exclusively share in the profits of PPS Insurance and those who have PPS Investments products can also share in the profits of PPS Investments.Job Advert Summary A member of the PPS Life Insurance Operations Accounts team reporting to the Team Leader Claims Administration. This role will be responsible for all the technical administration in the Claims Administration department. This will include working across all areas in Servicing and Administration with the ability to process in all facets of the department and resolve queries from start to end. They will be required to make decisions within their mandate and execute a higher quality of service combined with increased quantity as per the performance contract. Minimum Requirements Education: A tertiary qualification (NQF6 or above) with relevant business orientation advantages Experience: 2+ years of experience in an administration environment. Experience in the policy administration environment would be beneficial. Call Centre experience would be beneficial to assist with telephonic enquiries Knowledge and Skills: A good business acumen. Knowledge of Financial institutions (advantageous). Computer Literate (MS Office Package). Have excellent administration skills. Display attention to detail and analytical skills. Have strong organisational skills. Competencies: Ability to communicate clearly and effectively both verbally and in writing. Demonstrate good telephone etiquette. Have good problem-solving abilities. Be solution driven and take accountability and responsibility of own work. Deadline and target driven particularly in a production environment. Be adaptable. Have an ability to work within a teamwork environment . Have stress tolerance and resilience. Duties and Responsibilities Key Responsibilities: Quality assurance of claims documents received, as per the work instruction. Ensuring valid banking details linked to payment scheduler. Drafting of claims correspondence e.g. letters and emails. Verifying of member's contact details and personal information. Sending out of communication of claims correspondence, inclusive of attachments. Uploading of claims assessment correspondence/documents on system (correspondence, emails, reports referral sheets, stats, etc.). Correctly administer claim documents and claim correspondence as per the published work instruction. Maintaining Team service level agreement by ensuring daily targets achieved Assist Management and Support Team : Agree duties with team members in order to achieve operational targets including prioritization and work schedules. To execute policies and procedures related to service delivery in Operations and between other areas. Build and maintain relationships with relevant stakeholders Maintain Product Expertise: In order to answer customer complaints and questions, a Technical Administrator must be an expert in the products offered by PPS. This requires one to take the initiative to master every feature and benefit of each product. Identify process and procedure improvements and make recommendations to streamline and simplify processes.

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