PPS has more than 200 000 members who enjoy access to a comprehensive suite of financial and healthcare products that are specifically tailored to meet the needs of graduate professionals.
PPS is the largest South African company of its kind that still embraces an ethos of mutuality, which means that it exists solely for the benefit of its members. Thus, ...
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Job Advert Summary
This is a three-year internship position and is designed to be used as a springboard to launch a young graduate professional’s career in the financial industry.
The successful candidate must have the desire and long-term vision to build a professional practice for professionals by marketing risk and investment products from a well established platform. Because this period is recognised as the building period, the intern will have to be target orientated and motivated by incentive remuneration, as the package is incentivised and linked to sales targets.
The Graduate Advisor will be responsible for prospecting and building a client base within the young professional student base.
Minimum Requirements
Formal Qualifications:
- A relevant Bachelors degree or equivalent qualification is required
- CFP would be advantageous
- South African driver’s license and must have own transport
Experience and Knowledge:
- Insurance industry-related knowledge and experience would be advantageous
- Knowledge of the PPS product range and PPS membership would be an advantage
Computer Literacy:
- Computer Literate (MS Office Package)
Interpersonal and Intrapersonal Skills:
- Relating to customers within a diverse market
- Communication in writing.
- Communicating orally with good presentation skills.
- Quality orientated.
- Reliable.
- Customer focussed.
- Resilient
- Results driven.
Duties and Responsibilities
- Have a very focused approach toward becoming a professional Financial Planner.
- Host financial workshops for students and young professionals.
- Educate existing clients on sound financial principles.
- Guide students and young professionals to make the correct financial choices from the start.
- Liaise with a PPS Marketing Specialist on all marketing activities and workshops on campus.
- Make appointments with existing PPS student members to discuss the PPS student product range and benefits.
- Build a client base by selling the PPS student product range to PPS student members.
- Adhere to the regulation and compliance process of the financial industry.
- Stay up to date and excel in terms of qualifications and knowledge of the financial industry.
- Must be willing to be mentored and trained by experienced managers in this newly developed model.
go to method of application »
Job Advert Summary
This is a three-year internship position and is designed to be used as a springboard to launch a young graduate professional’s career in the financial industry.
The successful candidate must have the desire and long-term vision to build a professional practice for professionals by marketing risk and investment products from a well established platform. Because this period is recognised as the building period, the intern will have to be target orientated and motivated by incentive remuneration, as the package is incentivised and linked to sales targets.
The Graduate Advisor will be responsible for prospecting and building a client base within the young professional student base.
Minimum Requirements
Formal Qualifications:
- A relevant Bachelors degree or equivalent qualification is required
- CFP would be advantageous
- South African driver’s license and must have own transport
Experience and Knowledge:
- Insurance industry-related knowledge and experience would be advantageous
- Knowledge of the PPS product range and PPS membership would be an advantage
Computer Literacy:
- Computer Literate (MS Office Package)
Interpersonal and Intrapersonal Skills:
- Relating to customers within a diverse market
- Communication in writing.
- Communicating orally with good presentation skills.
- Quality orientated.
- Reliable.
- Customer focussed.
- Resilient
- Results driven.
Duties and Responsibilities
- Have a very focused approach toward becoming a professional Financial Planner.
- Host financial workshops for students and young professionals.
- Educate existing clients on sound financial principles.
- Guide students and young professionals to make the correct financial choices from the start.
- Liaise with a PPS Marketing Specialist on all marketing activities and workshops on campus.
- Make appointments with existing PPS student members to discuss the PPS student product range and benefits.
- Build a client base by selling the PPS student product range to PPS student members.
- Adhere to the regulation and compliance process of the financial industry.
- Stay up to date and excel in terms of qualifications and knowledge of the financial industry.
- Must be willing to be mentored and trained by experienced managers in this newly developed model.
go to method of application »
Job Advert Summary
This is a three-year internship position and is designed to be used as a springboard to launch a young graduate professional’s career in the financial industry.
The successful candidate must have the desire and long-term vision to build a professional practice for professionals by marketing risk and investment products from a well established platform. Because this period is recognised as the building period, the intern will have to be target orientated and motivated by incentive remuneration, as the package is incentivised and linked to sales targets.
The Graduate Advisor will be responsible for prospecting and building a client base within the young professional student base.
Minimum Requirements
Formal Qualifications:
- A relevant Bachelors degree or equivalent qualification is required
- CFP would be advantageous
- South African driver’s license and must have own transport
Experience and Knowledge:
- Insurance industry-related knowledge and experience would be advantageous
- Knowledge of the PPS product range and PPS membership would be an advantage
Computer Literacy:
- Computer Literate (MS Office Package)
Interpersonal and Intrapersonal Skills:
- Relating to customers within a diverse market
- Communication in writing.
- Communicating orally with good presentation skills.
- Quality orientated.
- Reliable.
- Customer focussed.
- Resilient
- Results driven.
Duties and Responsibilities
- Have a very focused approach toward becoming a professional Financial Planner.
- Host financial workshops for students and young professionals.
- Educate existing clients on sound financial principles.
- Guide students and young professionals to make the correct financial choices from the start.
- Liaise with a PPS Marketing Specialist on all marketing activities and workshops on campus.
- Make appointments with existing PPS student members to discuss the PPS student product range and benefits.
- Build a client base by selling the PPS student product range to PPS student members.
- Adhere to the regulation and compliance process of the financial industry.
- Stay up to date and excel in terms of qualifications and knowledge of the financial industry.
- Must be willing to be mentored and trained by experienced managers in this newly developed model.
go to method of application »
Job Advert Summary
PPS External Distribution has a one-year internship for a service driven young graduate professional with a strong need for financial independence who seeks superior training and experience in third party marketing and support in the financial services industry.
This is an outcome-based role where in-depth knowledge of holistic financial solutions and business insights will be tested as success factors at the end of the period. The intern will be exposed to a broad spectrum of critical areas which will range from client services, best practice principles, advice philosophy and network building to system support, product knowledge and data analytics.
Competency in business development and relationship management within a base of Life Assurance and Investments Intermediaries must be shown during the period and the Intern must work with and through others to build and maintain relationships. Working closely and accurately within established guidelines is essential in this role. The Intern must be aware of and responsive to the needs and concerns of customers.
Minimum Requirements
Qualification:
- Matric
- A three year or higher bachelor’s degree or national diploma
- A completed NQF 5 – Wealth Management
Experience:
- Since it is an internship, no experience is required, but experience in the financial services or Life Assurance and Investments industry in a sales and/or service related role will be an advantage
Duties and Responsibilities
Knowledge
- Intermediate knowledge of the Life Assurance and Investments or Financial Services Industry
- Knowledge (and skill) in how to successfully influence and persuade others by understanding how their individual needs and motivations link to goals is essential.
Operating Level Requirements (Scope, Responsibilities, Skills and Attributes)
Scope
- Reporting to the Area Manager, the Intern’s role involves business development and relationship management within a base of Life Assurance and Investments Intermediaries with the intention to grow this base.
- Focus will be 80% Risk & 20% Investments
- To support and service intermediaries in their sales efforts by preparing quotes, statement of benefits and other relevant supporting information.
- Constant communication and feedback to advisers relating to all aspects of intermediaries operations.
- To plan, organise and control liaisons with intermediaries, their managers
- To ensure continuous improvement of service standards to clients.
- To ensure alignment to Treating Customers Fairly (TCF), in all business practices
- To identify business opportunities based on data insights
go to method of application »
Job Advert Summary
PPS External Distribution has a one-year internship for a service driven young graduate professional with a strong need for financial independence who seeks superior training and experience in third party marketing and support in the financial services industry.
This is an outcome-based role where in-depth knowledge of holistic financial solutions and business insights will be tested as success factors at the end of the period. The intern will be exposed to a broad spectrum of critical areas which will range from client services, best practice principles, advice philosophy and network building to system support, product knowledge and data analytics.
Competency in business development and relationship management within a base of Life Assurance and Investments Intermediaries must be shown during the period and the Intern must work with and through others to build and maintain relationships. Working closely and accurately within established guidelines is essential in this role. The Intern must be aware of and responsive to the needs and concerns of customers.
Minimum Requirements
Qualification:
- Matric
- A three year or higher bachelor’s degree or national diploma
- A completed NQF 5 – Wealth Management
Experience:
- Since it is an internship, no experience is required, but experience in the financial services or Life Assurance and Investments industry in a sales and/or service related role will be an advantage
Duties and Responsibilities
Knowledge
- Intermediate knowledge of the Life Assurance and Investments or Financial Services Industry
- Knowledge (and skill) in how to successfully influence and persuade others by understanding how their individual needs and motivations link to goals is essential.
Operating Level Requirements (Scope, Responsibilities, Skills and Attributes)
Scope
- Reporting to the Area Manager, the Intern’s role involves business development and relationship management within a base of Life Assurance and Investments Intermediaries with the intention to grow this base.
- Focus will be 80% Risk & 20% Investments
- To support and service intermediaries in their sales efforts by preparing quotes, statement of benefits and other relevant supporting information.
- Constant communication and feedback to advisers relating to all aspects of intermediaries operations.
- To plan, organise and control liaisons with intermediaries, their managers
- To ensure continuous improvement of service standards to clients.
- To ensure alignment to Treating Customers Fairly (TCF), in all business practices
- To identify business opportunities based on data insights
go to method of application »
Job Advert Summary
- To take full accountability for the development and implementation of the risk management framework and risk policies for the Group and to drive the associated risk management activities and processes to identify, assess and manage Group risks ensuring adherence to regulatory requirements and recognizing business opportunities.
Minimum Requirements
Education:
- Degree NQF level 7 (B Com or other relevant degree) – Essential
- Post graduate degree NQF level 8 (B Com or other relevant degree) – Preferred
- Risk management diploma or other relevant risk qualification – Essential
- Member of Institute of Risk Management South Africa (IRMSA) – Preferred
Experience:
- Minimum 7 years of long-term insurance risk management experience of which at least 3 years in a management role – Essential
- Ability to engage with senior stakeholders at an executive and director level and debate and challenge where appropriate
- Drafting of policies and risk management frameworks for presentation to Directors – Essential
- Knowledge of Prudential Standards, Governance and Operational Standards for Insurers (GOI’s) – Essential
- CURA (risk management system) – Preferred
Knowledge and Skills:
- Facilitation
- Conflict Handling
- Analytical Thinking
- Detail orientated
- Problem solving and decision-making abilities
- Judgement
- Sense of urgency
- Results focus & Learning orientation
- Leading People
Duties and Responsibilities
Strategic Planning
- Formulate futures thinking approach and scenario planning by designing the scenario planning methodology, identifying the deliverables for scenario planning and managing the scenario development process including engagement and reporting to Senior Management, Executives and Directors.
- Recommend any deviations or changes from the risk management strategy, risk appetite and risk management procedures and tools as documented in the risk management policies and frameworks to the Risk Committee or Audit and Risk Committee (where applicable) for approval.
Risk management framework and policies setting
- Proactively and constructively manage the group risk management processes by setting risk management framework and policies, identification, assessment and management of risks and opportunities for the Group and meeting Prudential Standards requirements.
- Develop risk policies, frameworks and methodology by staying abreast of risk management industry developments and best practices.
- Embed an Enterprise Risk Management process throughout the Group by promoting awareness of risk management to both management and employees and ensuring effective risk management training programmes are established.
Risk identification, mitigation, monitoring and reporting
- Facilitate the identification & assessment of risks and assist business in developing risk mitigation plans by providing technical guidance to management in executing their risk management duties.
- Review risk reports and monitor risk mitigation plans by ensuring that appropriate plans for corrective action are put in place and obtaining feedback on progress made against action plans and ensuring delivery.
- Drive the implementation of climate-related risk and opportunity practices for the Group.
- Management of operational risk on a day-to-day basis including monitoring and reporting by developing an operational risk appetite and reporting on material incidents and associated losses against the approved operational risk limits and thresholds.
Key risk indicators setting
- Develop and monitor key risk indicators by identifying the forces that impact the critical risks in order to determine when the probability of a risk materializing is increasing.
- Benchmark current risk management practices against industry best practice and adjust/improve practices as and when necessary by developing systems for monitoring risk management including regular self-assessments of the risk management control function.
- Implement a Combined Assurance Model by identifying assurance providers and facilitating Control Self Assessments to ensure that all critical business risks are adequately assured.
Risk management maturity
- Provide input and assurance to the Board of Directors about the operations, efficiency and effectiveness of the components of the system for risk management.
- Communicate directly and regularly meet with the chairperson of the Risk Committee
- Promptly inform the Chairman of the Risk Committee of any circumstance that may have an adverse material effect on the risk management system.
Stakeholder management
- Co-ordinate all risk management regulatory reporting processes including the Own Risk and Solvency Assessment (ORSA) process and the SAM annual returns by ensuring that the information required by the regulators are submitted by business timeously and meets the regulatory requirements.
- Engage with regulators on a regular basis.
- Build strong relationships with internal and external stakeholders as a means to ensure objectives are met.
- Partner effectively with relevant stakeholders to determine key data points and metrics.
- Build cross-functional relationships and encourage collective accountability
People and culture
- Provide team leadership ensuring the effective implementation of strategy through leadership of the management team (setting individual objectives, managing performance, developing and motivating staff, provision of formal and informal feedback and appraisal) in order to ensure that the highest level of performance is achieved.
- Create a healthy and enabling organizational culture and climate, so that all employees are able to perform to their full potential and overall business performance is maximized.
- Accountable for strategic workforce planning; ensure that the team is sufficiently resourced to meet demand, compliance and the required customer experience.
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Job Advert Summary
Co-ordinate and oversee, manage negotiate and settle personal lines and commercial claims and account for the finalisation of the claim end-to-end. Delegate authority to manage the process and resolve any conflict by a negotiating, settlement, and finalisation functionality. Administer and validate claims correctly and efficiently within the specifications of PPS Short-Term Insurance Company's policy terms and conditions.
Minimum Requirements
Education:
- NQF Level 4: Grade 12
- Certificate of Proficiency in related field
Experience:
- 5+ years experience in a Short-Term Insurance Claims environment
- Short-term Insurance Industry experience will be advantageous.
- Codeplex experience would be an advantage.
Knowledge and Skills:
- Strong communication skills (written & verbal).
- Strong customer service skills.
- Service driven, with a focus on accuracy and quality of information delivered within service levels.
- Strong attention to detail.
- A strong work ethic and a drive to exceed expectations.
- Strong analytic and problem-solving skills.
- Adaptability to different stakeholders, audiences, and environments.
Competencies:
- Adapting and responding to change.
- Persuading and influencing.
- Deciding and Initiating Action.
- Coping with pressure.
Duties and Responsibilities
Validation of Insurance Claims
- Validate claims in a friendly, courteous, and professional manner to all stakeholders within the prescribed turnaround times as documented and agreed in various service level agreements
- Accurately document all interactions, decisions, and transactions related to the claims process. This includes maintaining detailed records of claim documents, correspondence, and any investigation findings
- Investigate the merits of a specific claim and determine if the services of an assessor / loss adjustor would be required and appoint the most appropriate preferred assessor / loss adjustor where necessary to perform further investigations
- Verify that all requirements are met (e.g. alarm systems, etc) in terms of the policy contract
- Confirmation of conflicting statements with relevant parties
- Make decision within financial mandate and within the set-out processes
Process optimization and efficiencies
- Duties include working with cross-functional teams to deliver exceptional service to all intermediaries/members as set out in the relevant service level agreements
- Combat insurance fraud by ensuring strict compliance to mandates, set procedures, philosophies and Company rules and regulations
- Identify opportunities for process improvements and efficiency enhancements within the claims handling department. Offer feedback and suggestions to enhance customer experience and streamline operations
- Uphold all service excellence principals as communicated by management
Stakeholder Management
- Build and maintain relationships with internal and external stakeholders
- Collaborate effectively with peers to achieve business results
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Job Advert Summary
Co-ordinate and assist with the administrative aspects of the overall claims process support for personal lines and commercial claims. Must have the ability to process in all facets of the Short Term Claims department and resolve queries from start to end. Delegate authority to manage the process and resolve any conflict between various role players internally and externally. Administer duties correctly and efficiently within the specifications of PPS Short-Term Insurance Company's policy terms and conditions.
Minimum Requirements
- Education: NQF Level 4: Grade 12
Experience:
- Experience in an claims 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:
- Strong communication skills (written & verbal).
- Strong customer service skills.
- Service driven, with a focus on accuracy and quality of information delivered within service levels.
- Strong attention to detail.
- A strong work ethic and a drive to exceed expectations.
- Strong analytic and problem-solving skills.
- Adaptability to different stakeholders, audiences, and environments.
- Computer literate (Microsoft Suite)
Competencies:
- Adapting and responding to change.
- Be solution driven and take accountability and responsibility of own work.
- Persuading and influencing.
- Deciding and Initiating Action.
- Collaboration.
- Coping with pressure.
Duties and Responsibilities
Key Responsibilities
- Assist in the processing of claim payments, settlements, and reimbursements. Coordinate with accounting and finance departments to ensure accurate and timely disbursement funds to policyholders or third-party claimants.
- Customer Service and Support Provide exceptional customer service to policyholders throughout the claims process.
- Co-ordination and support between all role players – internal and external.
- General administration assistance required in efficiently and timeously processing of claims.
- Claim Complaints handling and resolution.
Process optimization and efficiencies
- Duties include working with cross-functional teams to deliver exceptional service to all intermediaries/members as set out in the relevant service level agreements.
- Combat insurance fraud by ensuring strict compliance to mandates, set procedures, philosophies and Company rules and regulations.
- Uphold all service excellence principals as communicated by management.
Stakeholder Management
- Build and maintain relationships with internal and external stakeholders.
- Collaborate effectively with peers to achieve business results
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Job Advert Summary
This role reports to the Executive Underwriter. The Liaison Underwriter is responsible for underwriting life, disability, critical illness, sickness and permanent incapacity cover within agreed underwriting authority limits.
This role is crucial in building strong rapport with brokers to stay competitive in the dynamic market we operate in. Building and maintaining positive relationships with brokers and sales. The Liaison Underwriter will play a pivotal role in bridging the gap between underwriting decisions and effective communication with brokers as they will directly contribute to enhancing our ability to connect with brokers, provide tailored solutions, and ultimately strengthen our market position.
- The incumbent will deal with technical and complex underwriting queries and/or complaints providing an excellent service offering. A close relationship with Research & Development to support interdepartmental and wider organizational goals.
Minimum Requirements
Education:
- Financial / Medical aligned degree, e.g. Nursing, BCOM, BSC
Experience:
- 10+ years underwriting experience in long term insurance.
- 10+ years insurance industry experience.
- Proven experience in underwriting or related roles.
Knowledge and Skills:
- Sound medical & life assurance knowledge. Familiarity with industry regulations and compliance standards.
- Good computer knowledge - MS Outlook, Excel and Word are necessary.
- Must have a mature, disciplined and driven personality.
- Ability to work independently as well as being a good team-player with excellent interpersonal skills.
- Deadline/target driven, with ability to work under pressure.
- Have a skill set that includes good levels of communication (both written & verbal up to senior & executive level), negotiation and analytical skills.
- Excellent verbal and written communication skills.Strong interpersonal skills with the ability to engage effectively with clients.
- Ability to manage and prioritize multiple tasks efficiently.
- Detail-oriented with a focus on accuracy in documentation and communication.
- Competencies:
- Must use underwriting initiative and discretion in decision making.
- Business writing skills. Business Acumen.
- Planning and organizing.
- Client centricity.
- Building and maintaining relationships.
- Resilience.
- Complex problem solving.
- Adapting and responding to change.
- Innovation and Forward Thinking
- Persuading and Influencing
Duties and Responsibilities
Process optimization and efficiencies:
- The successful candidate will be responsible for underwriting life, disability, critical illness, sickness and permanent incapacity cover within agreed underwriting authority limits.
- To underwrite cases within the agreed service level agreements.
- Candidate must be willing to work under pressure and within agreed service levels.
- Responsible for achieving and maintaining standards in underwriting. Conduct regular audits on underwriting department and ensure standards are maintained.
- Provide constructive feedback to underwriting manager/underwriter team regarding matters arising.
Assess and authorize specific underwriting cases.
- Responsible for financial underwriting to ensure accurate financial underwriting decisions.
- Participation in projects to improve departmental service-owning your role in the project and completing tasks as required by providing input.
Liaison Champion:
- Assist in the creation and presentation of counter-offer letters to clients.
- Collaborate with underwriting team to tailor counter offers that align with client needs and company policies.
- Ensure timely delivery and follow-up on counter-offer responses.
Professionally handle declines by providing clear and comprehensive explanations to clients.
- Effectively communicate deferrals, managing expectations and offering guidance for future submissions.
- Serve as a bridge between underwriting decisions and client understanding, fostering positive relationships.
- Conduct tele-underwriting interviews with potential clients, showcasing strong interpersonal skills.
- Manage calls efficiently, asking probing questions to gather necessary information.
- Provide accurate and detailed information to clients while adhering to company guidelines and compliance standards.
- Discussing all adverse decisions with Financial Advisors (counter offer letters, Decline and defer.
Risk and Compliance:
- Adhere to internal SLA's to ensure operational efficiency and achievement of agreed customer service standards.
- Proficient in the assessment and management of underwriting decisions.
- Must understand the underwriting environment and general protocols and processes.
- Ensure adherence to regulatory and compliance requirements.
- Contribute and assist to review processes and protocols where required to assist in PPS’ delivery of quality underwriting decisions.
People and Culture:
- Checking and Authorization of underwriting decisions in terms of published delegation of authority.
- Collaboration with relevant stakeholders: Research & Development, Member Services and Intermediary Services.
- Deal with Arbitration and Ombudsman cases and collaborate with other stakeholder during the Complaints proces.
- Forge strong working relationships with stakeholders.
- Support Managers and Learning and Development to identify learning objectives; implement training interventions and create development plans.
- Support active learning plan for onboarding of new employees and constant learning for all employees through coaching and other interventions.
- Build and maintain strong relationships with clients, brokers, and other stakeholders.
- Act as a trusted advisor during the underwriting process, ensuring clients are well-informed and supported.
Knowledge Champion:
- Provide guidance and support to junior underwriters.
- Empower team members with transfer of knowledge, be the Underwriting Team SME.
- Ensure that own knowledge is kept abreast with industry & regulatory information and changes through various internal and external information sources. Regulations to provide informed and up-to-date support.
- Provide technical information and support.
- Refer cases to Reassurers.
- Underwriting Life, TPD, Critical Illness and IP cover.Proactively identify opportunities to enhance underwriting processes and communication strategies.
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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 (Degree/Btech) 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.
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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
Method of Application
Use the link(s) below to apply on company website.
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