Ex Gratia Coordinator at Momentum Metropolitan Holdings Limited

Role Purpose    

The role is responsible for the coordination of the Ex Gratia function as follows:

• Attending Scheme engagements, including but not limited to Ex Gratia meetings, and present performance 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    

• Matric or equivalent
• Relevant tertiary qualification will be an advantage
• Minimum of 3 - 5 years’ experience in Medical Aid Industry, in the same and or similar environment
• Proven track record of Client relationship
• Extensive computer experience on Ms Word, Ms Excel and Outlook
• Basic knowledge of claims and reading filters

Duties & Responsibilities    

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.
• Investigate and record all ex gratia approvals and submit for sign-off post Ex Gratia Committee meetings.

Competencies    

• Excellent Written and Verbal communication skills
• 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

Closing Date    

• 2026/04/12