Medical Aid Case Manager jobs

Job Purpose

Provide an effective and efficient conduit between ASI Financial Services (ASI) and its clients (i.e. members and appointed representatives of the organisation) through provision of advice, query resolution, administrative service, communication, training and education.

Key Responsibilities

• Demonstrate a good understanding of the Employee Benefits (medical scheme, employee wellness programme, expatriation health benefits etc.) industry and the products available in the market
• Conduct in-depth analysis of members’ financial needs and provide appropriate advice, record, save onto the CRM and provide member with a copy of the record of advice
• Ensure that members understand the benefits, exclusions, administration processes and procedures of their appointed schemes/funds••Advise members who are leaving their employers (retirement/resignations) of their options (e.g. continuation, transfers to private capacity etc.) and refer them to an authorised financial planner for advice
• Conduct and arrange onsite member assist sessions, inductions, and training sessions. Ensure meeting notes are sent out for these engagements
• Year end revision and medical scheme roadshows

ADMINISTRATION AND QUERY MANAGEMENT

• Attend to the resolution of members and/or employer queries. You are required to escalate complex queries to your senior consultant as soon as possible
• Save client communication on internal drive, keep record of attendance register for training sessions, on-site session, queries received and option change forms
• Request necessary data/information from schemes to support projects
• Assist with resolution of billing discrepancies, membership compliance audits
• Provide day to day assistance for general queries and updates on claims from members and HR
• Assist HR with updated claim forms upon request
• Persuade members to buy additional products to maximise their benefits (e.g. Vitality, Gap Cover, etc.)

Qualifications

• Grade 12 Matric/ National Senior Certificate
• FAIS Fit & Proper compliant (NQF Level 5, Regulatory Exams)
• 3 years’ experience in medical insurance / Health Care Administration

Competencies

• Exceptional written & verbal communication skills (English)
• Customer-focused mindset
• Problem Solving
• Attention to detail
• Deadline-driven

Job Types: Full-time, Permanent

Application Question(s):

• Do you own a roadworthy vehicle?
• What is your current salary CTC?
• In-Office & 80% in front of client

Experience:

• medical aid advisory: 3 years (Required)

License/Certification:

• RE5 (Required)
• Drivers Licence (Required)

Work Location: In person