Job Description

Closing Date 2025/05/06
Reference Number MMH250416-1
Job Title Junior Claims Risk Specialist
Position Type Permanent
Role Family Risk
Cluster Momentum Health
Remote Opportunity None of the time
Location - Country South Africa
Location - Province Western Cape
Location - Town / City Bellville
IntroductionThrough our client-facing brands Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.
Disclaimer As an applicant, please verify the legitimacy of this job advert on our company career page.
Role PurposeThe successful incumbent will collaborate closely with the Claims Risk Specialist to assist in the management and recovery of provider fraud debt.
RequirementsEducation

• Matric or equivalent qualification
• BCom degree or BCom in Accounting/Forensic Accounting or equivalent B-degree (required)

Experience

• At least 3 years experience working in an accounting, debt and recovery or forensic accounting environment
• Experience in Financial Crime Investigation is an advantage

Knowledge & Skills

• Proficient in Microsoft Office 365 (MS-Word, One Drive, MSExcel, MS PowerPoint, MS Outlook etc.)
• Above-average ability in MS Excel
• Excellent written and spoken communication skills

Duties & ResponsibilitiesProcess

• Assist with the updating of fraud debt reports to various governance bodies.
• Assist with the collation of documentation submitted for affordability assessments.
• Assist the Claims Risk Specialist with the preparation of debt memos following monthly governance meetings.
• Assist with acknowledgement of debt payment tracking and following up on arrears.
• Assist the Claims Risk Specialist with the preparation of block pay analysis reports and block pay reversal proposals for consideration by client governance bodies.
• Assist with the implementation of governance committee and client directives.
• Assist with contacting service providers to arrange acknowledgement of debt discussions.
• Assist in other administrative support required by the Claims Risk Specialist and the scheme.
• Attend Fraud debt management committee meetings with the Claims Risk Specialist and assist with noting and tracking and implementation of deliverables emanating from meeting.

Client

• Build and maintain relationships with clients and internal and external stakeholders.
• Deliver on service level agreements applicable to clients, internal and external stakeholders in order to ensure that client expectations are managed.
• Make recommendations to improve client service and fair treatment of clients within area of responsibility.
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
• Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery.
• Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advice and after sales service.
• Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes.

People

• Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations.
• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialisation.
• Positively influence and manage change and offer specialist support where required.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.
• Take ownership for driving career development

Finance

• Contribute to the development of area specific budgets to minimise expenditure, in alignment with operational plans.
• Identify solutions to enhance cost effectiveness and increase operational efficiency.
• Implement and provide input into governance processes, systems and legislation within area of specialisation.
• Escalate unresolved policy and governance compliance issues via appropriate channels for investigation and resolution purposes
• Provide input into the risk identification processes development and communicate recommendations in the appropriate forum.

Competencies

• Reliable
• Honest
• Positive and pleasant disposition
• High degree of personal integrity
• Self-driven
• Attention to detail

PolicyWe are committed to Employment Equity, diversity and inclusion when recruiting internally and externally. All appointments are made in alignment to our Employment Equity goals and we encourage people with disabilities to apply.

Momentum Group