Senior: Specialist Administrator

Role Overview

As the Specialist:
Claims Approval he/she must have the ability to check and apply expertise to data with an intended objective to deliver on the specific area of expertise. Furthermore, we could analyze data and extract trends to ensure improvement of processes and or customer satisfaction. This could be in the form of innovative ideas as well as the task of compiling reports.

Should be able to engage and list to current challenges in the team/business and use expertise to Trouble shoot issues in order to provide workable solutions. They must have the ability to tackle a Problem with the intent of using expertise/capability and or experience to resolve speedily. Investigate and manage improper payments and PFA related issues.

• Coordinate and monitor the complete claims processing cycle, ensuring that all claims, inquiries, and complaints (including those from the Pension Fund Adjudicator and FSCA) are handled in accordance with policies and SLAs.
• Ensure all claims are quality-assured and processed according to the relevant policies, legislation, and procedures.
• Policy & Procedure Development:
  Identify, enhance, and document proposals for policies and processes that improve the claim’s function.
• Engage in user acceptance testing of processes on Everest.
• Investigate and analyse escalated complaints or issues, report trends, and propose solutions to the reporting manager for approval and implementation.
• Assist administrators with data changes, rollbacks, delegations, and ad-hoc reporting as required.
• Tracking and managing inflow and outflow of work output in the team.
• Responsible for quality assessing (checking and releasing/ audit confirm) of withdrawal claims, death, and disability, that are processed correctly.
• Ensure tasks are completed with strict accuracy and within deadlines, focusing on high standards of work quality.
• Ensure that all daily, weekly and monthly stats reports are completed timeously.
• Flag and elevate work that has been started and not finalized to the manager.
• Ensure tracking and output of action items emanating from the trustee meetings.
• Implement, track and manage all controls in the team (movement of switches/merges etc.).
• Responsible for compiling data, preparing documents for audits and responding to audit queries.
• Identify, develop, enhance document and make proposals to implement policies, procedures and processes that are relevant to the Exits team.
• Investigate, analyse and monitor stops in the team.
• Report trends and obtain approval from the reporting manager for solutions to implement preventative measures.
• Ensure queries whether internal or external are dealt with professionally and within service level agreement.
• Accept accountability and take responsibility of all tasks assigned.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
• Participate in any additional duties as determined by the business needs and organizational events.
• Identify opportunities for improving claims processes and contribute innovative solutions to increase efficiency and accuracy.
• Uphold the company’s values and image in all interactions, ensuring professional conduct in both internal and external communications.

• Build and maintain relationships at all levels with reporting staff, all stakeholders and internal departments to enhance organizational effectiveness and efficiency.
• Use your best endeavours to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company.
• Report any irregularities to the reporting manager.

• Compile and provide accurate reports to the reporting manager, in the required format by the agreed deadlines, to keep management abreast of progress, delays and or backlogs.
• Maintain professional communication with clients, stakeholders, and internal teams, ensuring satisfaction and effective resolution of claims-related issues.
• Ensure that reports required by the trustees and business are managed timeously.

• Implement the culture transformation programme that will enable the…