Active Vacancies at PPS

Job Advert Summary
An exciting opportunity for a consultant exists in our Client Services Department.

The successful candidate must have excellent Scheme knowledge and will act as an Ambassador for PPSHA to ensure effective customer satisfaction.

Applications are invited for the above-mentioned position, to be filled as soon as possible.

Minimum Requirements
 Qualifications & Experience

• Grade 12
• 3-year Tertiary Qualification in any related field.
• 2 years or more experience in a Medical Call Centre environment.
• Sound knowledge of the Medical Aid Industry, Scheme Rules & Regulations, ISO and other related legislation.
• Effective business communication & writing skills with exceptional telephone etiquette (Fluency in Afrikaans is advantageous).
• Must be a strong team player and be able to work under pressure.
• Computer literacy and exposure to Medical Administration system will be an added advantage.

Duties and Responsibilities

• Effective and accurate recording and resolution of all enquiries.
• Maintain and ensure adherence to Service Levels Agreements.
• Facilitating corrections and providing feedback on resolution.
• Management of all priority and stale claim requests on behalf of members.
• Effective monitoring of Member’s accounts to ensure correct payments in accordance with Nappi, Reason and Agreed Tariff Codes.

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Job Advert Summary
Legal

• To assist business proactively and constructively in identifying and interpreting applicable legislation and minimise legal risks through the provision of legal advice and assistance to the business. 

Compliance

• To implement compliance risk management solutions within strategic guidelines and policies and to facilitate the management of compliance risks and breaches within the Business Unit through the application of accepted risk management principles

Minimum Requirements
Qualifications:

• Matric.
• LLB degree.
• Admitted as an attorney of the High Court (advantageous).
• Postgraduate Diploma in Compliance Risk Management (advantageous).

Experience:

• At least 2 years’ experience in financial services compliance, FAIS and short-term insurance experience will receive preference.

Knowledge:

• Knowledge of Financial services regulatory environment.
• General legislative knowledge.
• Demonstrated knowledge of Compliance Risk Management Methodology.
• Working knowledge of CURA (advantageous).
• Ability to write, communicate and interpret legislative requirement at the appropriate level.

Skills:

• Ability to independently solve complex legal problems in a systematic and logical manner.
• Ability to implement annual compliance plan.
• Ability to advise business on legal and compliance matters.
• Ability to write, communicate and interpret legislative requirement at the appropriate level.
• Ability to independently draft legal documents.
• Ability to conduct legal research.
• Good facilitation and conflict handling skills.
• Ability to collate information and to draft legal reports.
• Ability to partner with customers and/or colleagues to deliberate and discuss complex and/or sensitive issues with the aim of finding an appropriate solution.

Strategic Orientation:

• Knowledge and understanding of the financial services regulatory environment.
• Acts with confidence and works independently within a team environment.
• Provides input to Compliance strategies and plans.

Communication:

• Is articulate and communicates in a logical way and structures information to meet the needs and understanding of audiences on all levels.
• Expresses opinions, information and key points of view clearly and assertively

Interpersonal and Intrapersonal Skills:

• Excellent verbal, presentation and written skills.
• Facilitation.
• Conflict Handling.
• Influencing.
• Analytical Thinking.
• Operational Management.
• Collaborative.
• Sense of urgency.
• Results & Learning Orientation.

Computer LIteracy:

• Is proficient in the use of the latest MS Office packages, particularly Excel, Word and Power-point.

Duties and Responsibilities

• Project management and implementation of key compliance projects.
• Presentations to members of Exco, or key resources used by Exco, for delivery of projects.
• Key staff member of the legal and compliance team.
• Identify gaps or potential deficiencies in compliance and other business areas and resolve.
• Identify applicable legislation, provide comments, perform impact analysis and give advice and guidance to business.
• Implementation of requirements arising from new and amended regulatory items.
• Risk Assessment of Regulatory items.
• Maintain compliance risk assessments and compliant risk management plans for prioritised regulatory items on CURA.
• Manage breaches and risk exposures.
• Develop and maintain compliance monitoring plans.
• Conduct compliance monitoring activities, including compliance reporting.
• Draft legal contracts, policy documents etc. and review standard business communications.
• Provide advice to business on legal and compliance matters and implementation of controls, including control effectiveness assessments.
• Provide legal support to all areas of the business.
• Litigation management.
• Complaints management, including attending to all Ombudsman and Internal Arbitrator matters.
• Liaising with key stakeholders in the business, the FSCA, PA and other regulatory bodies when required.
• Compliance training on regulatory items.
• Training on compliance methodology
• Support business in providing necessary updates on CURA.

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Job Advert Summary

A member of the PPS Life Insurance Operations Accounts team reporting to the Team Leader Claims Administration. This role will be responsible for all the technical administration in the Claims Administration department.

This will include working across all areas in Servicing and Administration with the ability to process in all facets of the department and resolve queries from start to end. They will be required to make decisions within their mandate and execute a higher quality of service combined with increased quantity as per the performance contract. 

Minimum Requirements
Education: 

• A tertiary qualification (NQF6 or above) with relevant business orientation advantages 

Experience:

• 2+ years of experience in an administration environment.
• Experience in the policy administration environment would be beneficial.
• Call Centre experience would be beneficial to assist with telephonic enquiries

Knowledge and Skills:

• A good business acumen.
• Knowledge of Financial institutions (advantageous).
• Computer Literate (MS Office Package).
• Have excellent administration skills.
• Display attention to detail and analytical skills.
• Have strong organisational skills.

Competencies:

• Ability to communicate clearly and effectively both verbally and in writing.
• Demonstrate good telephone etiquette.
• Have good problem-solving abilities.
• Be solution driven and take accountability and responsibility of own work.
• Deadline and target driven particularly in a production environment.
• Be adaptable.
• Have an ability to work within a teamwork environment .
• Have stress tolerance and resilience.

Duties and Responsibilities 

Key Responsibilities:

• Quality assurance of claims documents received, as per the work instruction.
• Ensuring valid banking details linked to payment scheduler.
• Drafting of claims correspondence e.g. letters and emails.
• Verifying of member’s contact details and personal information.
• Sending out of communication of claims correspondence, inclusive of attachments.
• Uploading of claims assessment correspondence/documents on system (correspondence, emails, reports referral sheets, stats, etc.).
• Correctly administer claim documents and claim correspondence as per the published work instruction.
• Maintaining Team service level agreement by ensuring daily targets achieved 

Assist Management and Support Team :

• Agree duties with team members in order to achieve operational targets including prioritization and work schedules.
• To execute policies and procedures related to service delivery in Operations and between other areas.
• Build and maintain relationships with relevant stakeholders

Maintain Product Expertise:

• In order to answer customer complaints and questions, a Technical Administrator must be an expert in the products offered by PPS. This requires one to take the initiative to master every feature and benefit of each product. Identify process and procedure improvements and make recommendations to streamline and simplify processes.

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Job Advert Summary

• To analyze, reconcile, process information on a Claims account.
• To assess various type of claims submitted electronically / paper or received via fax or e-mail.  
• Assessing must meet both quality and quantity set standards.  
• To do corrections on accounts as requested by other departments or the Scheme.  
• To complete Reversals as requested by Internal Clients or any other third parties.

Minimum Requirements

• Grade 12
• Tertiary Qualification

Experience

• Medical Scheme Administration Experience 2 years essential
• Assessing experience 2 years plus essential
• Extensive understanding of the Administration System essential
• Knowledge of Reference Price List essential
• In-depth knowledge of Medical Scheme Rules essential
• MS Office
• Medical Scheme Act essential
• Knowledge of Medical Aid Legislation and regulations essential
• Knowledge of ICD 10 codes essential
• Knowledge of PMB legislation essential

Duties and Responsibilities

• Reconcile member or provider claims received.
• Accurate daily assessing of targets.
• Manage quality error percentage.
• Ensure consistent and excellent application of set standards and Scheme Rules.
• Excellent administrative skills e.g. daily record keeping.
• Escalate requests for corrections to relevant Consultant.
• Follow up and resolve routed enquiries.
• Good Communication
• Good administration skill’s, including record keeping and the ability to work under pressure
• Must maintain a high level of productivity to asses claims daily targets set
• High attention to detail in order to identify system risks or process shortfalls
• Must be quality aware and quantity orientated
• Operating System knowledge
• Excellent time management in order to manage deadlines
• Excellent in query resolution

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Job Advert Summary
The consultant will provide administrative, client and membership services within Intermediary Services and across the Life Operations business. The purpose of the role is to create a client experience that feels convenient, effortless and personal. It must feel bespoke to the client.

Will work in shifts that will be rotated amongst the team weekly (between 7am & 7pm weekdays and on Saturdays). There is a possibility that these might change in the future depending on growth and the need in the business. 

Minimum Requirements
Education:

• Matric.
• A 3-year tertiary qualification (Bachelors Degree/ Bachelor of Technology) with relevance business orientation

Experience:

• 2+ working experience in call centre and back-office processing is a clear advantage.
• Experience in the client service environment, advantageous 

Knowledge and Skills:

• The consultant is to be a highly self-motivated individual with strong relationship managing, leadership and communication skills.  
• Relationship management skills.
• Good business acumen.
• Can-do attitude while challenging convention.
• Knowledge of customer experience techniques.
• Knowledge of Financial institutions (advantageous).
• FAIS and FICA knowledge (advantageous)

Competencies:

• Able to thrive under constant pressure.
• Accuracy and attention to detail for all relevant work types.
• Ability to organise and prioritise.
• Team player.
• To act with integrity at all times, embrace the philosophy of treating our customers fairly and deliver on our client experience principles.  
• Competent writing and communication skills.
• Proactive thinking.
• Client Centricity.
• Results Driven.
• Able to motivate and inspire colleagues to achieve more

Duties and Responsibilities 

Key Accountabilities:

• The consultant will provide services (administrative and membership services) across the client sets.
• Information needs to be provided in accordance with legislative requirements.
• The purpose is to provide an exceptional telephonic service and online navigation for our clients and deliver against our client service principles.
• Responsibilities may include proactive contact with the clients or potential clients (membership).
• The consultant will also help to build and manage the daily operations of the business – processes, systems and projects. This will include developing internal controls for the business, testing and administration of the various systems, and running the operations of the business smoothly to ensure that clients are serviced in the PPS way. 

Respond to Customer needs:

• Engage and respond to customer’s contacts professionally regardless of channel.
• Take ownership of customer requests from receipt to conclusion.
• Identify and escalate issues to supervisors.
• Provide product and service information to all customers.
• Research required information using available resources.
• Research, identify, and resolve customer complaints using applicable software.
• Route calls to appropriate people where required.
• Document all requests according to standard operating procedures.
• Follow up customer calls where necessary.
• Complete call logs and reports.
• To take ownership of service level standards and ensure they are reached consistently.
• In addition to their regular duties of answering customers basic questions, an Operations Consultant is responsible for handling complaints that are too complex to be handled by junior employees.

Assist Management and Support Team:

•  Agree duties with team members in order to achieve operational targets including prioritization and work schedules.
• Responsible for enforcing PPS’s training and development program. They may also be assigned a junior employee to mentor.
• To execute and updated policies and procedures related to service delivery in Operations and between other areas.
• Build and maintain relationships with relevant stakeholders

Keep Track of Customer Trends:

• An Operations Consultant uses available software to document each customer interaction to help streamline the customer service process and notice trends to report back to the technical specialist and product development team.
• Identify process and procedure improvements and make recommendations to streamline and simplify processes.
• Escalate systems failures to the appropriate support team in order for the team to stay productive and process these failed cases when fixes are implemented.
• Recognize, document, and alert the management team of trends in customer calls

Maintain Product Expertise:

• In order to answer member/intermediary complaints and questions, an Operations Consultant must be an expert in the products offered by PPS. This requires one to take the initiative to master every feature and benefit of each product.