Jobs Available at Oneplan Underwriting Managers (Pty) Ltd

Duties & Responsibilities:

Authorisation Management:

• Oversee the entire insurance authorisation process for hospital services, including surgeries, treatments, and diagnostic procedures.
• Ensure all necessary documentation, including medical records, is submitted accurately and in a timely manner.
• Ensuring productivity and execution of authorisations are done timeously.
• Resolve issues with denied claims, claim queries or delayed authorisations.

Administrative Operations: 

• Supervise administrative staff responsible for managing patient / client registrations, billing, and other clerical functions.
• Implement efficient administrative workflows and ensure proper record-keeping.
• Collaborate with clinical departments to ensure smooth coordination between administrative and administrative functions from suppliers.
• Monitor compliance with health and safety regulations, data protection laws, and health care policies.

Financial Oversight:

• Collaborate with the finance department to track and monitor administration and authorisations for payment processing.
• Ensure accurate billing and timely invoicing based on authorized services.
• Oversee cost estimates for claims and review concerns related to the product policies for approval of claims.

Team Leadership:

• Lead and develop a team of administrative and authorisation staff, providing training and mentoring as needed.
• Set performance goals for the team and ensure they meet the established standards.
• Conduct performance reviews and provide ongoing feedback for team improvement.

Compliance & Reporting:

• Ensure adherence to all legal, regulatory, and accreditation standards related to hospital administration and insurance practices.
• Prepare regular reports on authorisations, denials, and pending claims for senior management.
• Maintain records of all authorizations, including dates, approvals, denials, and appeals.

Key Performance Indicators (KPIs):

Authorisation Approval Rate:

• Percentage of authorization requests approved on the first submission.
• Average time taken to secure approvals from insurance companies.

Claims Denial Resolution:

• Rate of resolved denied claims.
• Time taken to appeal, and resolve denied claims.

Client Satisfaction:

• Patient feedback on administrative processes, particularly regarding billing and insurance communication.
• Timeliness in addressing patient concerns and questions.

Operational Efficiency:

• Reduction in administrative processing times for admissions and discharges.
• Efficiency in coordinating patient authorizations with clinical schedules.

Team Performance:

• Achievement of team-based goals (e.g., meeting deadlines, accuracy of submissions).
• Staff retention and satisfaction within the administrative team.

Compliance Adherence:

• Zero incidents of non-compliance with health, safety, and insurance regulations.
• Number of audits passed with minimal issues.

Requirements

Key requirements of the role:

Education:

• Bachelor’s degree in business financial administration (BCom) and or Bachelor of science (BSc) or a related field, would be advantageous.
• Medical workplace experience working within a hospital or medical center for 2-3 years.
• Qualified Nurse with 3-5 years’ experience within the Health Service would be advantageous.
• Additional certifications in healthcare management or insurance billing are a plus.

Experience:

• 5+ years of experience in healthcare administration, including at least 2 years in an insurance authorisation or billing role.
• Proven experience managing a team in a healthcare setting.
• In-depth knowledge of health insurance policies, reimbursement processes, and authorization procedures.
• Familiarity with hospital administrative processes and insurance claim systems.
• Proficient in office management software and Microsoft Office Suite.
• Strong organizational and leadership skills.
• Excellent communication and interpersonal abilities.
• Ability to multitask and prioritize effectively in a fast-paced environment.
• Problem-solving skills and attention to detail.
• Highly administrative and accurate in execution of tasks.
• Proven experience as an Admin Manager or in a similar role, including motivating of staff and ensuring the team is highly productive.

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Key Responsibilities:

Lead Generation and Digital Campaign Management:

• Develop and execute multi-channel campaigns across digital platforms (Facebook, Google Ads, TikTok, Instagram, etc.) to drive lead generation and sales for health and pet insurance products.
• Implement A/B testing strategies to enhance campaign performance and conversion rates.
• Monitor and optimize campaigns and programs to ensure cost-effective lead generation.
• Stay informed about the company’s products, services, and brand to ensure accurate representation across marketing channels.
• Collaborate on content development to target audiences at various stages of the customer lifecycle.
• Identify new market opportunities and advertising tactics to support business growth.
• Secure buy-in and budget approval from senior leadership and stakeholders.
• Manage monthly digital campaign spending, ensuring efficient budget allocation.
• Ensure a lead mix with over 60% quality leads across digital platforms to meet daily and monthly targets aligned with the budget.
• Regularly analyse landing pages, website performance, and customer journeys to improve user experience (UX) and lead conversion.
• Continuously monitor digital platforms to manage budgets, maximize lead generation, and improve lead quality.
• Keep up with emerging technologies and platforms to enhance marketing strategies, improve ROI, and build brand awareness.
• Update and manage monthly lead spend within the allocated budget.

Analysis & Reporting:

• Provide weekly reports on lead conversions and adjust campaigns for optimal performance.
• Report on the effectiveness of above-the-line campaigns, providing insights into areas of improvement.
• Track, analyse, and report the impact of all digital marketing activities.
• Deliver weekly and monthly reports on key metrics such as lead generation, budget performance, and digital campaign success.

Project Support & Event Management:

• Execute digital campaigns, ensuring seamless communication and project management.
• Manage advertising efforts for events, e.g. Muddy Puppy Event.
• Assist the General Manager in executing new projects and business acquisitions.
• Identify opportunities for marketing promotions and business growth.
• Collaborate with internal teams (graphic design, copywriting, UX, and web development) to create engaging promotional materials.
• Manage the production and distribution of marketing material, ensuring adherence to project timelines and priorities.

Marketing and Brand Activities:

• Ensure that all marketing materials align with company brand guidelines and corporate identity (CI), maintaining accuracy and availability across platforms.
• Collaborate with internal departments to support initiatives requiring marketing and design resources.
• Uphold the integrity and values of the brand in all marketing activities, ensuring alignment with strategic objectives.
• Review and test product and plan information after any changes to ensure accuracy.
• Manage internal communications calendars and maintain consistency across communications.
• Perform any additional tasks as required by the company or executive management.

Team Leadership and Development:

• Provide leadership, vision, and direction to team members, fostering a collaborative and performance-oriented environment.
• Lead by example and motivate team members in line with core company values.
• Take responsibility for direct reports' performance, ensuring they meet quality standards and objectives.
• Support team members’ professional development through training, coaching, and mentoring.
• Foster a culture of continuous learning and innovation within the team.

Cross-Functional Collaboration:

• Promote a culture of respect and understanding across departments.
• Encourage and facilitate collaboration between teams to overcome barriers and foster information sharing.
• Engage with internal and external stakeholders to develop joint solutions that drive marketing and business success.

Requirements

Key Requirements of the Role:

Education:

• Bachelor’s degree in marketing, Digital Marketing, or a related field; postgraduate qualifications are preferred.
• Certifications in design and digital marketing are advantageous.

Experience:

• Minimum of 5 years’ experience in digital campaign management and lead generation, ideally within insurance or a related field.
• Experience in digital design, lead generation, and campaign management, particularly in marketing insurance products, will be advantageous.
• Proven ability to lead and inspire a dynamic team.
• Strong organizational skills, with the ability to prioritize tasks and manage multiple projects in a fast-paced environment.