Introduction
Company
One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA.
Purpose
To perform quality control on all admin updates, to stay in touch with operational requirements. The quality controller is also responsible for managing a financial profile. Assistance on an ad-hoc basis may be required to ensure optimal functioning.
Duties & Responsibilities
Responsibilities
- Review, maintenance, and monitoring quality and turnaround.
- Outstanding information review and feedback.
- Monitoring weekly stats per allocated Consultant.
- Correspondence to all stakeholders with a personally yours approach, measuring feedback as per weekly outstanding report and response to stakeholder internal/external.
- Reporting and active involvement in projects.
- Process information, communicate with stakeholders, investigate and correct member profiles.
- Test membership changes by due date. Assist with data clean-up.
- Enhance processes and raise red flags.
- Admin Errors versus output, financial errors, and impact assessment. POPIA breach risk control.
- Admin turnaround, SLA as reported weekly, average will be measured.
Desired Experience & Qualification
- Minimum 4-5 years previous Medical Scheme Industry experience.
- Membership administration experience of 4-5 years.
- Minimum 3-4 years underwriting experience.
- Grade 12.
- Diploma in Business Management or related field.
Package & Remuneration
R Negotiable on Experience.
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