Permanent
Pretoria
Posted 7 months ago

Together with our client who is a leader in IOD claims administration, we are recruiting for a Team Leader in IOD/WCA Claims.

Duties & Responsibilities

  • Assess COID claim information
  • Assess billing on account per item in terms of COID Gazette
  • Assess accounts against payment history received from COID
  • Practice management of assigned practices
  • Effective communication with assigned practices
  • Assisting with client support and operational queries on accounts submitted;
  • Provide medical advice and/or direction on claims to clients;
  • Following up on outstanding information required from clients and employers for processing of medical claims and invoices;
  • Resolve enquiries from clients related to the COID Act and medical treatment of patients;
  • Contribute to daily operations; and
  • Endure that all procedures are followed and that all production goals are met.
  • Adhere to production deadlines.
  • Assist to accomplish set revenue targets.
  • Assist with training of newly appointed staff in the same division.
  • Updating DS system with the relevant claim numbers from the Compensation Fund system.
  • Upload of medical reports in the prescribed format on the Compensation Fund system.

Key Accounts and Decision Pending Duties

  • Overall responsible for the business unit:
  • Overseeing the operational work load and distribution to both teams;
  • Ensuring that all procedures are followed and that all production goals are met;
  • Providing feedback to Management in scheduled meetings as well as on request;
  • Managing of staff including all related HR functions e.g., performance agreements, disciplinary procedures, adherence to company policies, etc;
  • Assisting with the management of divisional throughput and incentives;
  • Recruitment and on -the -job training of staff;
  • Attending/hosting meetings with Key clients as required and also accompany the Head of Client Relations on client meetings where required; and
  • Liaising with Sales Representatives for assistance on Key clients and Decision Pending accounts where required.
  • Contributing to daily operations of the business:
  • Client service as core duty; resolving outstanding information on accounts received; on-site client assistance; training; and account collection;
  • Taking ownership of allocated client relationships;
  • Continuous improvement of relationship with clients;
  • Liaison and weekly feedback reporting to the Head of Client Relations.

Quality Control Duties

  • Head the Technical Advisory Committee mandated to enforce quality and standards throughout the company;
  • Ensuring that proper quality control procedures are implemented and maintained throughout all operational processes;
  • Perform weekly quality checks on work processed for the week with the aim of eliminating non-recovery risks; and
  • Analyse invoice submissions to Funders, rejections and payments received to identify trends of potential quality control failures to improve the overall quality footprint in the Company.

Training Duties

  • Take ownership of all internal training programs;
  • Review existing training program and restructuring the content of internal programs (beginner, intermediate, advanced);
  • Conduct internal training sessions with the support of the other trainers to upskill staff at all levels of the company; and
  • Together with the other Unit managers ensure continuous revision and enhancement of internal training programs

Other Duties (Ad-hoc tasks)

  • Ad hoc tasks in line with the company’s objectives as and when required; and
  • Other duties that may arise from time to time as directed by the Chief Executive Officer.

Salary:

R 22 000.00  – R28 00.00 CTC per Month

If you meet the above requirements, please send your cv to recruitment2@medicalresources.co.za with REF: Team Leader

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