Ex Gratia Coordinator

Introduction

Through our client-facing brands Metropolitan and Momentum, with Multiply (wellnessandrewards programme), and our other specialist brands, including Guardrisk and ErisPropertyGroup, the group enables business and people from all walks of life to achievetheir financialgoals and life aspirations. We help people grow their savings, protect whatmatters to themand invest for the future. We help companies and organisations care forand reward theiremployees and members. Through our own network of advisers or viaindependent brokersand utilising new platforms Momentum Metropolitan providespractical financial solutions forpeople, communities, and businesses.

Disclaimer

As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose

• Attending Scheme engagements, including but not limited to Ex Gratia meetings, and present cases and reports, where required
• Building and maintaining relationships with key stakeholders
• Preparation and submission of meeting documents and reports to the Scheme
• Performing Secretarial Role at the Ex Gratia Committee Meetings
• Executing all Scheme Related Directives and Mandates

Requirements

Qualification

• Matric or equivalent
• Relevant Degree or Diploma in an Administration field (Advantageous)

Knowledge

• Extensive knowledge and experience in the medical aid administration industry (Advantageous)
• Intermediate knowledge of claims

Skills

• Excellent Written and Verbal communication skills
• Planning and organising skills.
• High attention to detail.
• A high level of interpersonal skill that supports positive relationship building. Ability to interact with a range of stakeholders in a professional manner
• Client service orientation
• Perform under pressure in a deadline driven environment
• Ability to work independently and to function effectively within a team
• Excellent planning, time management and organising skills
• Strong decision making capabilities

Experience

• Minimum of 3 - 5 years’ experience in Medical Aid Industry, in the same and or similar environment
• Proven track record of Client relationship management
• Extensive computer experience on Ms Word, Ms Excel and Outlook

Duties & Responsibilities

Internal Process

• Coordinate and provide a professional service to GEMS where special grants are awarded, in cases where medical expenditure, in excess of the Scheme’s available limits, has caused or would cause financial hardship for members.
• Keep accurate documentation and reports of all processed, approved and rejected Ex Gratia cases and ensure that these are recorded into the system.
• Perform quality checks on cases and outcome letters prepared.
• Ensure all cases are completed accurately and comply with internal policies before referral to Medical Advisors and the Ex Gratia Committee.
• Maintain accurate records of all filters loaded, usage of approved grants and amounts authorised by the Scheme’s Ex Gratia committees.
• Efficient and accurate investigations, administration and communication of all Ex Gratia applications and queries.
• Establish and maintain knowledge of Ex Gratia Guidelines, Scheme Rules, Benefit Exclusions and Claims operational systems for GEMS.
• Distribute meeting Agenda and documentation prior to Committee meeting in accordance with the Scheme’s Service Level Agreement.
• Attend and participate in the Ex Gratia Committee meetings.
• Present prepared Ex Gratia applications to the Committee.
• Make recommendations to the Committee with regards to Ex gratia applications received.
• Capture all application decisions and actions from the Ex Gratia Committee meetings.
• Provide secretarial services to the relevant meeting and provide minutes of the meeting to the Ex Gratia Committee.
• Prepare accurate and up to date statistics relating to Ex gratia applications processed for a particular reporting period.
• Prepare all quarterly reports as required by the Ex Gratia Committee.

Client

• Build and maintain relationships with clients and internal and external stakeholders
• Deliver on service level agreements applicable to clients and internal and external stakeholders in order to ensure that client expectations are managed
• Make recommendations to improve client service and fair treatment of clients within area of responsibility
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service
• Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery
• Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advice and after sales service.
• Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes

People

• Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations.
• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialisation.
• Positively influence and manage change and offer specialist support where required.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.
• Take ownership for driving career development

Finance

• Contribute to the development of area specific budgets to minimise expenditure, in alignment with operational plans.
• Identify solutions to enhance cost effectiveness and increase operational efficiency.
• Implement and provide input into governance processes, systems and legislation within area of specialisation.
• Escalate unresolved policy and governance compliance issues via appropriate channels for investigation and resolution purposes
• Provide input into the risk identification processes development and communicate recommendations in the appropriate forum.

Competencies

• Business Accumen
• Building Strong Relationship
• Sense of urgency, focus, accountability, agility and execution
• Change Management
• Persuades, convinces, infl uences and inspires others
• Inclusivity and Humility
• Manages self and relationships with others