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Momentum Metropolitan Holdings, formerly MMI Holdings, is a South African-based financial services group was established on 1 Dec 2010, through the merger of Metropolitan and Momentum. We are specialists in long and short-term insurance, asset management, savings, investments, healthcare administration, health risk management, employee benefits and reward...
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Requirements
- Matric Certificate
- BCom Degree would be an added advantage
- Previous management (junior/senior) in a Claims Department
- Preference given to candidates who have previously worked in an EB environment with a minimum of 3 years
- Working knowledge of Reinsurance claims systems
- Working knowledge of all MS Office Applications
- Prior handling and exposure to any type of 1st party product
- At least 5 years claims management experience
- At least 10 years insurance industry experience
- At least 3 years policy wording interpretation experience
Duties & Responsibilities
- Provide coaching, support, and assistance to claims staff (1st & 3rd Party claims staff)
- Assessment and Management of all PTD Lump Sum, PHI, TTD, GLA, Hospital, Retrenchments, Critical Illness/Dread Disease & Funeral
- Assessment and Management of all Dread Disease, PHI and TTD, PTD Lump Sum payment calculations
- Attend monthly client meetings where applicable
- Ad hoc projects (System enhancements etc)
- Attending to complex 1st & 3rd Party matters
- Ensuring regulatory requirements are adhered to
- Performing claims reviews when required
- Claims sampling on 1st Party claims
- Providing guidance and feedback on complex claims and ensuring fair and equitable decisions are made
- Dealing with applicable Reinsurer on complex claims
- Dealing with clients on referrals
- Making recommendations of changes to policy terms for any client
- To assist with 3rd party claims processing, assessment & management when required by management
- Oversee and perform claim review processes with the focus on mitigating risk exposures to Guardrisk and ensuring overall compliance with regulatory requirements
- The facilitation of identification of gaps/trends or exceptions and escalate to cell captive/binder holder/ PM. Document actions to identify gaps
- Manage and assist, where required with the drafting and presentation of monthly team reports
- To provide ongoing guidance to claims staff on technical aspects
- Maintain and develop new and existing working relationships with internal and external stakeholders
- Understanding Rule 17 of the PPR’s and the TCF framework and the impact it has on day-to-day functions within the business unit
- Management of an effective 1st & 3rd party claims environment
- Continually review internal workflow processes to improve service delivery
- Ensuring that fair and equitable decisions are made on all 1st party claims
- Effective management of complex matters and providing guidance and/or instruction to cell captives/binder holders
- Dealing directly with applicable Reinsurers and relevant stakeholders in the decision-making process, the handling of complex matter and dealing with referrals
- To assist with 3rd party claims management when required by management
- Responsible for the capturing of all claims onto the Cell/Binder Source system and or GR Cell Administration system (Neo)
- Attending to ad-hoc tasks/Projects when required
Competencies
- PC skills, including experience in using software for producing presentations, spreadsheets, and project planning
- Project management
- Ability to interact with all levels including executives and directors
- Strong interpersonal, presentation, analytical and review/audit skills
- Excellent organizational skills and the ability to prioritize multiple tasks and projects using effective time management skills
- Strong written and verbal communication skills
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Requirements
- Registered Nurse with Degree or Diploma (General, Psychiatric and Midwife) is essential
- Current registration with the SANC, on application
- Diploma in Theatre Technique or ICU (or minimum 3 years relevant experience) is essential.
- RPL course would be an advantage
- At least 5 years of post-graduate clinical experience is essential.
- At least 3 years of Managed Care/Medical Aid industry experience is essential.
- Strong knowledge of PMB legislation, Clinical Coding (ICD10, CPT & NHRPL), hospital anddoctor's billing guidelines ishighly advantageous.
- Strong Oracle system knowledgeand CARM rules is an advantage
Duties & Responsibilities
- Review specific hospital claimsfor clinical appropriateness,treatment received, over usage ofequipment/ materials, and consistency with billing rules.
- Apply scheme rules, clinicalpolicies, and protocols
- Liaise with the medical advisor if necessary
- Review and maintain clinical auditing rules (CARM) annually.
- To identify hospital trends andclaiming patterns with the objective of changing provider behavior and giving continuous feedback to the business.
- Clinical support to provider network team and discussing identified trends to provider team.
- Attend quarterly HRM operationalmeetings and feedback regardingtrends and application of billingguidelines.
- Action clinical auditing work andvolumes timeously and within set service level agreement
- Assist with auth-claim matching queries
- Ensure accurate savings isrecorded according to pay codes and reason codes; reviewing automated monthly savings report.
Competencies
- Excellent problem solving skills
- Accurate and vigilant
- Target oriented
- Ability to work under pressureand meet deadlines
- Analytical thinking and investigative mind
- Conceptual thinking
- Attention to Details
- Self-Motivation
- Teamwork focused
- Analytical Thinking
- Good time management skills
- Quality orientated
- Trend management focus
- The ability to apply, maintain and expand professional and technical knowledge in order todeliver a better service to customers and improv eperformance, including sharing knowledge and experience with others.
- Excellent verbal Communication
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Requirements
- Matric
- At a minimum, a certificate in customer servicing training or call centre skills and administration skills
- Computer literate - basic computer skills knowledge and experience, specifically in MS Office
- At least 1-year inbound call centre experience
- At least 1-year administration experience
- Previous gap cover or medical scheme servicing or administration experience would be advantageous
Duties & Responsibilities
- Receiving of incoming calls into the Admed call centre during office hours, in a professional and friendly manner
- Telephonic membership, premium and claims query handling through accessing the Admed administration system
- Managing of difficult and/or irate callers in a courteous, polite and calm manner
- Where a query cannot be handled from the call centre, routing telephonic queries to the relevant back office team members and ensuring that the queries are dealt with in a timely manner
- Where necessary, taking and distributing of messages to relevant team members in a timely manner
- Making outbound calls from the Admed call centre as-and-when necessary and instructed
- Ensuring a high level of customer service when liaising with individual and corporate customers, intermediaries, binder holders and colleagues
- Where high email volumes necessitate, providing support to the mailbox team for overflow inbound emails
- Efficiently managing of complaints received and ensuring that every complaint is dealt with professionally
- Assisting with any general and reasonable ad hoc administration requests as necessary across the Admed Division
- Ensuring that the principles of TCF are delivered across every function performed, with a specific focus on the achievement of TCF Outcome 6 (Customers do not face unreasonable post-sale barriers to change product, switch provider, submit a claim or make a complaint)
Competencies
- Excellent verbal, written and interpersonal communication skills
- Ability to professionally manage angry customers, listen to customers’ needs and communicate clearly with customers telephonically
- Results and solutions driven with a strong sense of responsibility and ownership
- Discipline, reliable and good time management skills
- Strong customer service orientation
- Strong administration skills – attention to detail and accurate
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Requirements
Qualifications:
- NQF 7 Degree in Business Management.
- A BCom or BCom Honours degree. (preferred)
- Certificate in Financial Planning or working towards it. (advantageous)
Experience:
- 5-10 years' experience in corporate business development / corporate client service, sales or marketing within a financial services environment.
- 2-3 years’ experience in key account management or relevant client relationship management experience.
Duties & Responsibilities
Engaging:
- Acquire a thorough understanding of the Key Account's own strategic objectives, initiatives, needs and requirements.
- Plays a pivotal role in comprehending the requirements.
- Successfully control, execute, monitor, and communicate Key Account engagements.
Enthusing:
- Delivering customised solutions per key account
- Create an action plan per Key Account indicating specific objectives, key deliverables with milestones and dates identified for the next 12 months to implement value proposition elements.
- Create and manage the alignment between Key Account Management (KAM), Head of Distribution (HOD), and the regional teams.
- The Key Account Manager will also need to provide support and resolution of queries in their areas of responsibility, as well as build and manage excellent client relationships.
Enabling:
- Create a profile per Key Account, providing all stakeholders with a clear understanding of the Key Account.
- Socialise the objectives and action plan to internal task team and all stakeholders.
- Drive the implementation of value proposition elements with various internal business areas and sales areas to execute on the action plan.
- Communicate progress on the implementation plan with all stakeholders.
- Develop and maintain and facilitate productive and collaborative working relationships with all stakeholders.
- Contribute to the budget planning process and identify opportunities to enhance cost effectiveness and increase operational efficiencies.
- Manage financial and other company resources under your control with due respect.
Empowering:
- Interrogate performance reports per key account to identify areas of opportunity and potential risks
- Provide input into the risk identification processes and communicate recommendations in the appropriate forum.
- Identifies new opportunities and make recommendations to improve client service and partnership to achieve business outcomes.
- Enables the growth of new business sales and achieves set targets for key accounts.
Competencies
- Deciding and Initiating Action
- Leading & Supervising
- Working with people
- Relating and Networking
- Persuading & Influencing
- Presenting & Communicating information
- Analysing
- Formulating strategies & concepts
- Plan & organizing
- Adapting & respond to change
- Coping with pressure & setbacks
- Achieving personal work goals & objectives
- Enterprise & Commer thinking
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Requirements
Qualifications:
- BCom degree in the following fields: Financial Planning, Financial Management, Investments, Business Management.
- Honours degree is an advantage.
- CFA and/or CFP® is an advantage.
Experience:
- 5 to 8 sales distribution experience
- 5 to 8 years’ financial service industry experience with majority in Business development management.
- Momentum Investments, Myriad and/or Investo experience an advantage.
Knowledge:
- Knowledge of the financial industry and industry related business process experience is required.
- Strong business acumen, with an ease to take decisions and initiating action
Duties & Responsibilities
Recruit IFAs to Adviser Partnerships Value Proposition
- Positioning Adviser Partnerships value propositions to IFAs in collaboration with consultants.
- Continuously drive the attraction and retention of IFAs contracted to Momentum Advisor Partnerships per region.
- Provide regular Momentum product sales and production feedback.
- Mobilise, motivate support the consultants through a trust relationship.
- Sustain and motivate MDS distribution team to support the deployment of Momentum Advisor Partnerships.
- Support consultants and their panels according to the panel management practice.
- Monitor the number of meaningful IFA consultations done by consultants weekly and monthly to ensure visibility.
- Build pivotable relationships with all key stakeholders, including the Momentum product houses and external stakeholders.
- Acquire new sustainable IFA Adviser Partnerships within the regions.
Drive Adviser Partnership value proposition creation
- Develop and execute the business plan outlined by MDS Advisor Partnerships for the respective regions.
- Set and uphold performance standard in the team to continuously attract new IFAs.
- Set & achieve annual, quarterly, and monthly sales targets for each consultant in the region with respect to Adviser Partnerships.
- Develop and drive growth in sales distribution that is in support of strategic objectives of MDS.
- Business development manager relentlessly drive the MDS Strategy, the sales numbers, and the focus areas in meeting agreed targets and objectives.
- Business development manager is proactively on-top of and own the targets that they have set. They fully understand and communicate the story behind the adviser’s requirements, the trends, and deviations. They highlight the insights that come from IFA interactions and utilise it to develop a plan to rectify any shortcomings.
Drive the IFA Connection and Commitment
- Business development manager should take ownership of their IFA relationships and build endearing and value adding relationships on behalf of Momentum.
- Take ownership of the IFAs in the regions to build meaningful and mutually beneficial relationships between the advisers and Momentum.
- Drive clear communication between IFAs and consultants.
- Actively monitor and report on IFA engagement and team output to the broader MDS.
- Ensure advice-led and best practice principles engagements with IFAs.
- Drive sound financial and corporate governance practices.
- Ensure greater share of IFA’s practice new business flows to Momentum products.
- Grow our MDS IFA Footprint and productive advisers.
Competencies
- Deciding and initiating action: Takes responsibility for actions, projects and people; takes initiative and works under own direction; initiates and generates activity and introduces changes into work processes; makes quick, clear decisions which may include tough choices or considered risks.
- Leading & supervising: Provides others with a clear direction; motivates and empowers others; recruits staff of a high calibre; provides staff with development opportunities and coaching; sets appropriate standards of behaviour.
- Working with people: Shows respect for the views and contributions of other team members; shows empathy; listens, supports and cares for others; consults others and shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
- Adhering to principles & values: Upholds ethics and values; demonstrates integrity; promotes and defends equal opportunities, builds diverse teams; encourages organisational and individual responsibility towards the community and the environment.
- Learning & researching: Rapidly learns new tasks and commits information to memory quickly; demonstrates an immediate understanding of newly presented information; gathers comprehensive information to support decision making; encourages an organisational learning approach (i.e. learns from successes and failures and seeks staff and customer feedback).
- Formulating strategies & concepts: Works strategically to realise organisational goals; sets and develops strategies; identifies, develops positive and compelling visions of the organisation’s future potential; takes account of a wide range of issues across, and related to, the organisation.
- Planning & organizing: Sets clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organizes resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
- Delivering results & meeting customer expectations: Focuses on customer needs and satisfaction; sets high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic, methodical and orderly way; consistently achieves project goals.
- Adapting & responding to change: Adapts to changing circumstances; tolerates ambiguity; accepts new ideas and change initiatives; adapts interpersonal style to suit different people or situations; shows an interest in new experiences.
- Coping with press & setbacks: Maintains a positive outlook at work; works productively in a pressurized environment; keeps emotions under control during difficult situations; handles criticism well and learns from it; balances the demands of a work life and a personal life.
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Requirements
- Relevant Bachelor’s Degree
- Professional qualification an advantage (CA, Actuary, Attorney etc.)
- CFP accreditation or actively working towards obtaining in the next 6 months
- All FAIS requirements in place
- 8 - 10 years client consulting experience within employee benefits environment
- Relevant retirement fund and/or employer solutions experience.
- In depth understanding of local Insurance laws, practices and regulatory requirements
Duties & Responsibilities
- Responsibilities and work outputsContributes to the consulting strategy that will enable and grow the consultants to be professional and well-respected advisors.
- Contribute to the development and packaging of financial services (including retirement, insurance and healthcare) solutions and ensure that operational considerations and clients/ clients’ employees’ financial wellness needs are incorporated into the development process.
Ensuring the execution and delivery of the consulting strategy that will include inter alia the following:
- Monitoring quality of agenda packs
- Monitoring timeous delivery of agenda packs and minutes
- Building and improving relationships with clients.
- Attending and providing input to consulting forums
- Providing input to standard agendas covering all the relevant topics
- Develop initiatives to improve or enhance the client experience.
- Oversee the assessment and analysis of service delivery gaps and challenges and implement remedial action strategies.
- Manage the development and implementation of quality management processes which ensure service delivery is line with the client and their employee’s expectations and requirements
- Create strategic partnerships with clients and stakeholders to understand business priorities and requirements.
- Take responsibility for advice given by consultants.
- Manage the client/ client’s employees’ experience received from the consultants to ensure client’s financial wellness needs are being successfully addressed.
- Deliver authoritative, expertise and advice framework.
- Build and maintain relationships with consultants and internal/ all stakeholders
- Contribute to the process of negotiating objective and realistic service level agreements, monitor appropriateness and recommend adjustments
- Make recommendations to improve client service and fair treatment of clients and their employees within area of responsibility
- Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service
- Educate and make consultants aware of potential distribution contact between channels
- Develop the necessary P&L strategy and tactics to close identified business, including all necessary sales activity, prospect calls and correspondence to prospects, presentations and executive meetings.
- Explain and agree on targets and take accountability for the overall achievement of performance objectives in the business area.
- Facilitate the achievement of set targets by driving sales performance.
- Manage and drive the turnaround time in terms of targets to ensure a high sales performance.
- Manage the delivery of deviance reporting monthly / as and when requested, to provide recommendations and mitigating solution to deviances that have occurred (e.g. service and sales targets not met).
CLIENT
- Maintain a strong understanding of products and services and innovating new ways to serve businesses
- Continuously spot/identify market opportunities for new customers
- Attend industry events and conferences, on a regular basis, to generate new business leads and represent/act as a spokesperson for Momentum Corporate at these various platforms to attract more, potential clients
- Expanding product offerings to all existing membership
- Build and promote strong, long-lasting and strategic partnerships with internal and external stakeholders by partnering with them and understanding their needs
- Incorporate client feedback into the enhancement of daily business processes and management of operating systems
SELF DEVELOPMENT AND TEAM MANAGEMENT
- Create a positive work climate and culture to energise consultants, give meaning to work, minimise work disruption and maximise consultant productivity.
- Demonstrate exemplary leadership behaviour, through personal involvement, commitment and dedication in support of organisational values.
- Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement and cohesiveness.
- Enable a learning and growth culture whereby information regarding successes, issues, trends and ideas are actively shared between team members.
- Identify consultant growth and development needs and schedule interventions to enable ongoing development, training and personal growth.
- Effectively manage performance within the consulting team in order to ensure business objectives are achieved
FINANCE
- Manage own team budget and ensure achievement of set targets
- Implement and provide feedback on the effectiveness of risk management, financial, governance and compliance policies, practice and procedures preventing illegal, unethical or improper conduct and manage governance and risk exposure liability.
- Identify solutions to enhance cost-effectiveness and increase operational efficiency.
Competencies
- Business Acumen
- New Business development
- Negotiation skills
- Relationship Building
- Stakeholder management skills
- Conflict Management
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Qualifications
- Matric or equivalent NQF Level 4 qualification
- FAIS Representative Regulatory Exam Level 5 passed
- 120 credit FAIS recognised qualification
Experience
- 3-5 years’ working experience in the insurance industry environment
- A Minimum of 2 years managerial experience in overseeing the rendering of financial advice to fulfil the duties of a compliant key individual and be registered with the FSP
- FAIS Tier 1 & 2 financial products (Long term insurance products, Pension benefit products and Collective investment scheme products)
- Class of Business 3 and 7 (Preferable)
Skills and Knowledge
- Relationship building
- Networking
- Good communication
- Computer Literacy
- Financial services industry (relevant legislation, product and process knowledge, Class of Business knowledge
- People Management
Other requirements
- Driver’s license and own vehicle
Duties & Responsibilities
INTERNAL PROCESS
- Managing a team of Financial Advisors
- Develop plans to achieve sales targets in line with client centric practices.
- Manage the adherence to operational processes, policies, and legislative requirements.
- Develop action plans and initiatives to drive sales, motivate team and improve performance.
- Communicate and implement approved team targets within area of responsibility.
- Implement action plans to achieve sales targets and business goals.
- Effectively manage all day-to-day team activities and escalations.
- Collaborate with Quality Assurance and Performance Coaches to guide and coach team to increase productivity, compliance, and quality of calls.
- Regularly assess team members’ performance against targets and implement actions to increase performance.
- Assess service delivery based on engagements with business stakeholders and relevant analytics and implement plans for improvement.
- Maintain effective and efficient record keeping on the relevant system.
- Conduct regular engagement with team members to cascade information and team objectives.
- Cultivate and manage working relationships with a variety of stakeholders.
- Analyse, identify trends and report on team performance and productivity.
- Implement effective staffing and scheduling models for guaranteed coverage at the lowest possible costs.
- Implement measures to address non-performance within the team.
- Identify operational efficiencies and make recommendations for improvement.
CLIENT
- Drive client service delivery goal achievement in line with predefined standards 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.
- Provide regular reports on delivery of services.
- Provide authoritative, expertise and advice to clients and stakeholders.
- 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 provide exceptional client service.
PEOPLE
- Create a positive work climate and culture to energise employees, give meaning to work, minimise work disruption and maximise employee productivity.
- Demonstrate exemplary leadership behaviour, through personal involvement, commitment, and dedication in support of organisational values.
- Select and recruit suitably qualified talent in line with Employment Equity principles and Momentum Metropolitan values.
- Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement, and cohesiveness.
- Enable a learning and growth culture whereby information regarding successes, issues, trends, and ideas are actively shared between team members.
- Support effective workforce planning practices to ensure that staffing requirements are accurately forecasted.
- Identify employee growth and development needs and schedule interventions to enable ongoing development, training, and personal growth.
- Effectively manage performance within the team in order to ensure business objectives are achieved. Encourage innovation, change agility and collaboration within the team.
FINANCE
- Give input into the budget for area and implementation of financial regulations.
- Implement and provide feedback on the effectiveness of financial policy, practice and procedures preventing illegal, unethical or improper conduct.
- Implement risk management, governance, and compliance policies in own practice area, to identify and manage governance and risk exposure liability.
- Investigate reported wilful acts of non-compliance to organisation policy and practice and report on findings.
Competencies
- Business Acumen
- Client/ Stakeholder Commitment
- Drive for Results
- Leads Change and Innovation
- Motivating and Inspiring Team
- Impact and Influence
- Collaboration
- Self-Awareness and Insight
go to method of application »
Qualifications
- Matric or equivalent NQF Level 4 qualification
- FAIS Representative Regulatory Exam Level 5 passed
- 120 credit FAIS recognised qualification
Experience
- 3-5 years’ working experience in the insurance industry environment
- A Minimum of 2 years managerial experience in overseeing the rendering of financial advice to fulfil the duties of a compliant key individual and be registered with the FSP
- FAIS Tier 1 & 2 financial products (Long term insurance products, Pension benefit products and Collective investment scheme products)
- Class of Business 3 and 7 (Preferable)
Skills and Knowledge
- Relationship building
- Networking
- Good communication
- Computer Literacy
- Financial services industry (relevant legislation, product and process knowledge, Class of Business knowledge
- People Management
Other requirements
- Driver’s license and own vehicle
Duties & Responsibilities
INTERNAL PROCESS
- Managing a team of Financial Advisors
- Develop plans to achieve sales targets in line with client centric practices.
- Manage the adherence to operational processes, policies, and legislative requirements.
- Develop action plans and initiatives to drive sales, motivate team and improve performance.
- Communicate and implement approved team targets within area of responsibility.
- Implement action plans to achieve sales targets and business goals.
- Effectively manage all day-to-day team activities and escalations.
- Collaborate with Quality Assurance and Performance Coaches to guide and coach team to increase productivity, compliance, and quality of calls.
- Regularly assess team members’ performance against targets and implement actions to increase performance.
- Assess service delivery based on engagements with business stakeholders and relevant analytics and implement plans for improvement.
- Maintain effective and efficient record keeping on the relevant system.
- Conduct regular engagement with team members to cascade information and team objectives.
- Cultivate and manage working relationships with a variety of stakeholders.
- Analyse, identify trends and report on team performance and productivity.
- Implement effective staffing and scheduling models for guaranteed coverage at the lowest possible costs.
- Implement measures to address non-performance within the team.
- Identify operational efficiencies and make recommendations for improvement.
CLIENT
- Drive client service delivery goal achievement in line with predefined standards 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.
- Provide regular reports on delivery of services.
- Provide authoritative, expertise and advice to clients and stakeholders.
- 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 provide exceptional client service.
PEOPLE
- Create a positive work climate and culture to energise employees, give meaning to work, minimise work disruption and maximise employee productivity.
- Demonstrate exemplary leadership behaviour, through personal involvement, commitment, and dedication in support of organisational values.
- Select and recruit suitably qualified talent in line with Employment Equity principles and Momentum Metropolitan values.
- Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement, and cohesiveness.
- Enable a learning and growth culture whereby information regarding successes, issues, trends, and ideas are actively shared between team members.
- Support effective workforce planning practices to ensure that staffing requirements are accurately forecasted.
- Identify employee growth and development needs and schedule interventions to enable ongoing development, training, and personal growth.
- Effectively manage performance within the team in order to ensure business objectives are achieved. Encourage innovation, change agility and collaboration within the team.
FINANCE
- Give input into the budget for area and implementation of financial regulations.
- Implement and provide feedback on the effectiveness of financial policy, practice and procedures preventing illegal, unethical or improper conduct.
- Implement risk management, governance, and compliance policies in own practice area, to identify and manage governance and risk exposure liability.
- Investigate reported wilful acts of non-compliance to organisation policy and practice and report on findings.
Competencies
- Business Acumen
- Client/ Stakeholder Commitment
- Drive for Results
- Leads Change and Innovation
- Motivating and Inspiring Team
- Impact and Influence
- Collaboration
- Self-Awareness and Insight
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Requirements
- Matric/ Grade 12
- 3 – 4 years claims assessing experience preferred
- Excellent literacy, numeracy, and communication skills
- Multi discipline claims knowledge
- Good knowledge of PMB at industry level as well as in house PMB processes
- Good knowledge of modifiers and their application
- Proven experience in the assessing of medical aid claims (paper and/or EDI) will be adventageous
- Computer literacy (especially Email, Word and Excel)
- Passionate about driving a high-performance culture
- The ability to interpret and apply scheme rules correctly
- Knowledge of the NHRPL- National Health Reference Price List (Previously Known as BHF) and SAMA Tariffs
Duties & Responsibilities
- Accurate and timeous resolution of Claims Queries.
- Correctly reverse and reprocess the related claim
- Ensuring that no duplicate claims are paid during the process
- Appropriate pay code is applied
- Assisting other departments with claims related queries
- Liaising with other departments to resolve queries
- Recording all queries and interactions with customers onto the workflow system
- High quality and service output
Competencies
- Attention to detail and accuracy
- Problem solving ability
- Ability to function effectively within a team
- Ability to work under pressure
- Consistently works to meet expectations
- Resolves client problems within his or her job scope
- Is engaged and demonstrates energy in the execution of tasks
- Accepts accountability for own mistakes and ensures corrective action is taken
go to method of application »
Qualifications
- Matric or equivalent NQF Level 4 qualification
- FAIS Representative Regulatory Exam Level 5 passed
- 120 credit FAIS recognised qualification
Experience
- 3-5 years’ working experience in the insurance industry environment
- A Minimum of 2 years managerial experience in overseeing the rendering of financial advice to fulfil the duties of a compliant key individual and be registered with the FSP
- FAIS Tier 1 & 2 financial products (Long term insurance products, Pension benefit products and Collective investment scheme products)
- Class of Business 3 and 7 (Preferable)
Skills and Knowledge
- Relationship building
- Networking
- Good communication
- Computer Literacy
- Financial services industry (relevant legislation, product and process knowledge, Class of Business knowledge
- People Management
Other requirements
- Driver’s license and own vehicle
Duties & Responsibilities
INTERNAL PROCESS
- Managing a team of Financial Advisors
- Develop plans to achieve sales targets in line with client centric practices.
- Manage the adherence to operational processes, policies, and legislative requirements.
- Develop action plans and initiatives to drive sales, motivate team and improve performance.
- Communicate and implement approved team targets within area of responsibility.
- Implement action plans to achieve sales targets and business goals.
- Effectively manage all day-to-day team activities and escalations.
- Collaborate with Quality Assurance and Performance Coaches to guide and coach team to increase productivity, compliance, and quality of calls.
- Regularly assess team members’ performance against targets and implement actions to increase performance.
- Assess service delivery based on engagements with business stakeholders and relevant analytics and implement plans for improvement.
- Maintain effective and efficient record keeping on the relevant system.
- Conduct regular engagement with team members to cascade information and team objectives.
- Cultivate and manage working relationships with a variety of stakeholders.
- Analyse, identify trends and report on team performance and productivity.
- Implement effective staffing and scheduling models for guaranteed coverage at the lowest possible costs.
- Implement measures to address non-performance within the team.
- Identify operational efficiencies and make recommendations for improvement.
CLIENT
- Drive client service delivery goal achievement in line with predefined standards 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.
- Provide regular reports on delivery of services.
- Provide authoritative, expertise and advice to clients and stakeholders.
- 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 provide exceptional client service.
PEOPLE
- Create a positive work climate and culture to energise employees, give meaning to work, minimise work disruption and maximise employee productivity.
- Demonstrate exemplary leadership behaviour, through personal involvement, commitment, and dedication in support of organisational values.
- Select and recruit suitably qualified talent in line with Employment Equity principles and Momentum Metropolitan values.
- Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement, and cohesiveness.
- Enable a learning and growth culture whereby information regarding successes, issues, trends, and ideas are actively shared between team members.
- Support effective workforce planning practices to ensure that staffing requirements are accurately forecasted.
- Identify employee growth and development needs and schedule interventions to enable ongoing development, training, and personal growth.
- Effectively manage performance within the team in order to ensure business objectives are achieved. Encourage innovation, change agility and collaboration within the team.
FINANCE
- Give input into the budget for area and implementation of financial regulations.
- Implement and provide feedback on the effectiveness of financial policy, practice and procedures preventing illegal, unethical or improper conduct.
- Implement risk management, governance, and compliance policies in own practice area, to identify and manage governance and risk exposure liability.
- Investigate reported wilful acts of non-compliance to organisation policy and practice and report on findings.
Competencies
- Business Acumen
- Client/ Stakeholder Commitment
- Drive for Results
- Leads Change and Innovation
- Motivating and Inspiring Team
- Impact and Influence
- Collaboration
- Self-Awareness and Insight
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Requirements
- Matric.
- Recognition of prior learning(preferred).
- Minimum of 4 years of experience in employee benefits.
Duties & Responsibilities
- Check and verify all financial and non-financial operational transactions including client interactions accurately and within the agreed turnaround times and service level agreements ensuring no daily backlog in quality queues.
- Identify and clearly note gaps in transactional processing performance or service delivery and give concise recommendations/feedback for corrections and improvements in service delivery on relevant platforms for immediate action by operations service consultants and to allow accurate reporting on up-skilling and development to the operational management team.
- Contribute to the identification of business services process issues and development of solutions, escalating to the Quality Control Portfolio Manager to determine the best operational course of action.
- In collaboration with the Portfolio Manager implement and take joint accountability for the service response to the Momentum Corporation Operational business strategy.
- Contribute and ensure compliance with relevant legislation and risk mitigation strategies.
- Deliver on service level agreements to ensure that the overall client expectations are managed.
- Make recommendations to improve client service and fair treatment of clients within the area of responsibility.
- Participate and contribute to a culture that builds rewarding relationships, facilitates feedback and provides exceptional client service.
- Adopt a performance culture that exceeds service delivery expectations maintaining high quality output within service level agreement.
- Adopt a culture of accountability for personal, regional and cross regional queue management to ensure full turn-around time of quality control items is maintained.
- Understand the impact of the quality effort to overall client experience.
- Take full accountability for personal management of own service standard delivery.
- Build strong relationships through providing consistent and accurate concise recommendation/feedback, expressing positive expectations to improve overall high-quality client service experience.
- Exceed client expectations by adopting a cross regional team culture.
- Positively influence and participate in change initiatives.
- Continuously develop own expertise in terms of operational process changes, industry and legislation knowledge.
- Contribute to continuous innovation through the development, sharing and implementation of new ideas.
- Take ownership for driving career development.
- Manage financial and other company resources under your control with due respect.
- Provide input into the risk identification processes and communicate recommendations in the appropriate forum.
- Check and verify all operational processes and client interactions timeously and accurately to avoid re-works and late processing penalties.
Adopt a culture of excellence ensuring zero defects / errors in overall client experience from Momentum Corporate operational teams.
Competencies
- Collaboration.
- Customer orientation.
- Impact and influence.
- Accountability.
- Adaptability.
- Attention to detail.
- Communication skills.
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Requirements
- 2 years’ experience in a sales and/or customer service role
- 2 years’ experience in the insurance and/or financial services industry rendering financial advice (advantageous)
- Matric or equivalent NQF 4 qualification
- Compliance with FAIS Fit and Proper requirements
- Finance or Business related tertiary qualification (desirable)
- Driver’s license and own transport (desirable)
Duties & Responsibilities
INTERNAL PROCESS
- Engage with prospective clients in order to highlight the features and benefits of various products based on their financial wellness needs in order to support and guide their decision-making process.
- Sell products in line with client’s financial needs by conducting affordability analysis in order to achieve clients’ financial goals.
- Calculated and advise on tax and legal implications of products and or changes.
- Accurately capture client information, relevant actions and sales on the systems.
- Accurately complete all administrative and reporting requirements within agreed timeframes.
- Achieve set targets on production, quality and conversion.
- Adhere to compliance requirements in the sales process in line with legislative requirements.
- Provide financial advice in line with the engagement strategy to enhance client’s financial wellness.
CLIENT
- Investigate client queries within the agreed service level and ensure that client receives timeous feedback.
- Escalate client queries to the relevant department or stakeholder.
- Provide accurate information and advice to clients and stakeholders in order to ensure that the client receives the appropriate services.
- Provide regular reports on delivery of services against agreed service level agreements and in terms of overall customer targets. Provide authoritative, expertise and advice to clients and stakeholders.
- Build and maintain relationships with clients and internal and external stakeholders.
- 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.
- Proactively build and maintain client relationships by presenting our innovative and trustworthy product offerings through professional and credible Financial Advisory services.
PEOPLE
- Develop and maintain productive and collaborative working relationships with peers and stakeholders.
- Positively influence and participate in change initiatives.
- Continuously develop own expertise in terms of professional, industry and legislation knowledge.
- Contribute to continuous innovation through the development, sharing and implementation of new ideas.
- Take ownership for driving career development.
FINANCE
- Identify solutions to enhance cost effectiveness and increase operational efficiency.
- Manage financial and other company resources under your control with due respect.
- Provide input into the risk identification processes and communicate recommendations in the appropriate forum.
Competencies
- Examining Information: Analyse and process information; ask probing questions and strive to find solutions to problems.
- Interacting with People: Project enthusiasm and focus on building strong relationships and networks.
- Convincing People: Comfortable having to persuade others; shape opinions by being outspoken and seek to negotiate with others.
- Articulating Information: Be eloquent and explain concepts well and project social confidence when articulating information.
- Thinking Positively: Optimistic and positive; recover easily from setbacks and obstructions.
- Meeting Timescales: Strong focus on meeting target and deadlines
go to method of application »
Requirements
- 2 years’ experience in a sales and/or customer service role
- 2 years’ experience in the insurance and/or financial services industry rendering financial advice (advantageous)
- Matric or equivalent NQF 4 qualification
- Compliance with FAIS Fit and Proper requirements
- Finance or Business related tertiary qualification (desirable)
- Driver’s license and own transport (desirable)
Duties & Responsibilities
INTERNAL PROCESS
- Engage with prospective clients in order to highlight the features and benefits of various products based on their financial wellness needs in order to support and guide their decision-making process.
- Sell products in line with client’s financial needs by conducting affordability analysis in order to achieve clients’ financial goals.
- Calculated and advise on tax and legal implications of products and or changes.
- Accurately capture client information, relevant actions and sales on the systems.
- Accurately complete all administrative and reporting requirements within agreed timeframes.
- Achieve set targets on production, quality and conversion.
- Adhere to compliance requirements in the sales process in line with legislative requirements.
- Provide financial advice in line with the engagement strategy to enhance client’s financial wellness.
CLIENT
- Investigate client queries within the agreed service level and ensure that client receives timeous feedback.
- Escalate client queries to the relevant department or stakeholder.
- Provide accurate information and advice to clients and stakeholders in order to ensure that the client receives the appropriate services.
- Provide regular reports on delivery of services against agreed service level agreements and in terms of overall customer targets. Provide authoritative, expertise and advice to clients and stakeholders.
- Build and maintain relationships with clients and internal and external stakeholders.
- 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.
- Proactively build and maintain client relationships by presenting our innovative and trustworthy product offerings through professional and credible Financial Advisory services.
PEOPLE
- Develop and maintain productive and collaborative working relationships with peers and stakeholders.
- Positively influence and participate in change initiatives.
- Continuously develop own expertise in terms of professional, industry and legislation knowledge.
- Contribute to continuous innovation through the development, sharing and implementation of new ideas.
- Take ownership for driving career development.
FINANCE
- Identify solutions to enhance cost effectiveness and increase operational efficiency.
- Manage financial and other company resources under your control with due respect.
- Provide input into the risk identification processes and communicate recommendations in the appropriate forum.
Competencies
- Examining Information: Analyse and process information; ask probing questions and strive to find solutions to problems.
- Interacting with People: Project enthusiasm and focus on building strong relationships and networks.
- Convincing People: Comfortable having to persuade others; shape opinions by being outspoken and seek to negotiate with others.
- Articulating Information: Be eloquent and explain concepts well and project social confidence when articulating information.
- Thinking Positively: Optimistic and positive; recover easily from setbacks and obstructions.
- Meeting Timescales: Strong focus on meeting target and deadlines
go to method of application »
Requirements
- 2 years’ experience in a sales and/or customer service role
- 2 years’ experience in the insurance and/or financial services industry rendering financial advice (advantageous)
- Matric or equivalent NQF 4 qualification
- Compliance with FAIS Fit and Proper requirements
- Finance or Business related tertiary qualification (desirable)
- Driver’s license and own transport (desirable)
Duties & Responsibilities
INTERNAL PROCESS
- Engage with prospective clients in order to highlight the features and benefits of various products based on their financial wellness needs in order to support and guide their decision-making process.
- Sell products in line with client’s financial needs by conducting affordability analysis in order to achieve clients’ financial goals.
- Calculated and advise on tax and legal implications of products and or changes.
- Accurately capture client information, relevant actions and sales on the systems.
- Accurately complete all administrative and reporting requirements within agreed timeframes.
- Achieve set targets on production, quality and conversion.
- Adhere to compliance requirements in the sales process in line with legislative requirements.
- Provide financial advice in line with the engagement strategy to enhance client’s financial wellness.
CLIENT
- Investigate client queries within the agreed service level and ensure that client receives timeous feedback.
- Escalate client queries to the relevant department or stakeholder.
- Provide accurate information and advice to clients and stakeholders in order to ensure that the client receives the appropriate services.
- Provide regular reports on delivery of services against agreed service level agreements and in terms of overall customer targets. Provide authoritative, expertise and advice to clients and stakeholders.
- Build and maintain relationships with clients and internal and external stakeholders.
- 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.
- Proactively build and maintain client relationships by presenting our innovative and trustworthy product offerings through professional and credible Financial Advisory services.
PEOPLE
- Develop and maintain productive and collaborative working relationships with peers and stakeholders.
- Positively influence and participate in change initiatives.
- Continuously develop own expertise in terms of professional, industry and legislation knowledge.
- Contribute to continuous innovation through the development, sharing and implementation of new ideas.
- Take ownership for driving career development.
FINANCE
- Identify solutions to enhance cost effectiveness and increase operational efficiency.
- Manage financial and other company resources under your control with due respect.
- Provide input into the risk identification processes and communicate recommendations in the appropriate forum.
Competencies
- Examining Information: Analyse and process information; ask probing questions and strive to find solutions to problems.
- Interacting with People: Project enthusiasm and focus on building strong relationships and networks.
- Convincing People: Comfortable having to persuade others; shape opinions by being outspoken and seek to negotiate with others.
- Articulating Information: Be eloquent and explain concepts well and project social confidence when articulating information.
- Thinking Positively: Optimistic and positive; recover easily from setbacks and obstructions.
- Meeting Timescales: Strong focus on meeting target and deadlines
go to method of application »
Requirements
- A National Senior Certificate is essential
- It is essential to have a Nursing Diploma or Degree
- Minimum of 2 years clinical experience within a private hospital is essential
- The incumbent must be registered with the South African Nursing Council as a Registered Nurse
- A certificate in ICD-10 coding is highly advantageous
- Experience in a managed care / case management environment would be an advantage
- MS Office / Office 365 proficiency
Duties & Responsibilities
- Review of in-hospital patients for appropriateness of care, length of stay and level of care.
- Liaise with the service provider on clinical updates, as well as outstanding information.
- Engage with the treating doctor(s) to ensure appropriate treatment, length of stay and level of care is rendered.
- Discharge planning for in-hospital patients to ensure ongoing support and care post discharge.
- Develop, implement and communicate the practice and/or clinical guidelines for cost effective care.
- Authorise appropriate and cost-effective surgical care and treatment.
- Ensure the consistent and correct application of exclusions.
- Adhere to policies and procedures and take corrective action where necessary.
- Adhere to organisational best practice and legislative requirements.
- Take ownership of escalated and unresolved queries and ensure they are resolved timeously.
- Manage queries until resolution and update the incident details.
- Identify financial and business risks to the company and escalate accordingly.
- Provide clinical support to non-clinical team’s if/when required.
- Drive and support effective teamwork within the department.
- Strive to demonstrate the company's values daily.
- Engage in hospital visits where needed to build stakeholder relationships, proactively resolve queries and increase visibility to members.
- Ensure the effective, accurate and timeous completion of relevant documentation and recording of interventions.
- Communicate with providers to improve the cost efficiencies of health care delivery.
- Ensure Service Level Agreements are met and exceeded.
- Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialisation.
Competencies
- Effective communication skills – verbal and written
- Accountability
- Planning and organising
- Problem solving
- Time management
- Attention to detail
- Interpersonal skills
- Customer orientation
- Results driven
- Empathetic nature
- Business Administration skills
Method of Application
Use the link(s) below to apply on company website.
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