Momentum Client Services 

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1. Multi-Skilled Claims Investigator (KZN)
2. Contribution & Membership Consultant

Multi-Skilled Claims Investigator (KZN)

Closing Date	2024/05/10
Reference Number	MMH240426-1
Job Title	Multi-Skilled Claims Investigator (KZN)
Position Type	Permanent
Role Family	Client Services
Cluster	Momentum Insure Company Limited
Remote Opportunity	Some of the time
Location – Country	South Africa
Location – Province	KwaZulu-Natal
Location – Town / City	Durban
Introduction	Through our client-facing brands Metropolitan and Momentum, 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. Through our own network of advisers or via independent brokers and utilising new platforms Momentum Metropolitan provides practical financial solutions for people, communities and businesses. Visit us at www.momentummetropolitan.co.za
Role Purpose	To contribute to the organisational goals by investigating, negotiating and administering claims. Identify and prevent fraudulent claims and manage expenditure on settled claims.
Requirements	MatricFAIS accreditation or a FAIS recognised qualification will be highly beneficialMinimum experience of 3 years investigative experience in Personal and commercial claims environmentOwn reliable vehicle
Duties & Responsibilities	Receive personal and commercial line claims identified by the fraud prediction model for validationConfirm merits of each claim through comprehensive assessment of the item and incidentApply the policy to ensure the loss is covered in terms of the contractCompile a comprehensive report on all findings and make a recommendation on a claim based on merits/evidence found during the validation processRefer all recommendations not within your mandate to the line manager for approvalIrrespective of the outcome of the claim the broker, client and claims advisor to be notified (rejected claims to be communicated verbally and in writing)The key focus of a claims investigator is to limit financial losses due to a policy/claim fraud and to finalise and adjust claims accurately obtain all evidence in a proper manner to ensure that it is admissible as evidence in a court of lawAct as complainant where fraud is found and render all assistance and evidence to ensure the prosecution of the person who committed/attempted to commit fraudAssist/influence other areas of the business once an investigation is concluded, i.e. report on the quality of the sale/policy wording and application or adjustment of underwriting criteriaReport on any risks identified and suggested controls and report any other failures which influences the merits of an investigationInternal Process:Enhance service delivery in the claims departmentsContribute to optimising work practices and procedures via suggestionsUp skill/influence claims advisors by sharing knowledgeEffectively build, maintain and manage relationships with clients, brokers, service providers and business partnersEnsure investigations are done in a professional manner and all parties are updated regularly on the progressAchieve minimum standards with regards to saving ratios, turnaround time, Customer Satisfaction scores, Ombudsman overturned ratios and expense ratiosPeople:Live the Momentum valuesInteract with colleagues and supply manager investigation resultsInteract with other business units i.e. claims, client services, brokers, compliance, legal etc.Build relation/interact with support services to ensure effecienciesInteract with clients, brokers and service providers
Competencies	Attention to detailCritical thinkingAnalytical SkillsTime managementInterpersonal skills

Contribution & Membership Consultant

Closing Date	2024/05/02
Reference Number	MMH240422-1
Job Title	Contribution & Membership Consultant
Position Type	Temporary
Role Family	Client Services
Cluster	Health Solutions
Remote Opportunity	None of the time
Location – Country	South Africa
Location – Province	KwaZulu-Natal
Location – Town / City	Cornubia, Durban
Introduction	Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.
Role Purpose	To capture new applications and perform membership changes and to collect, reconcile and allocate monies for premiums and surcharges.
Requirements	MatricBook keeping/ or Administrative qualification is an advantageMinimum of 3 years relevant Membership experience is essentialComputer literacy preferably intermediate Excel and WordOracle system knowledge is an Advantage Minimum of 3 years in Health experience and Client services will be an adavantage
Duties & Responsibilities	Their ability to identify problems and enhance processes in line with the department’s goals.Process membership changes and new applications within agreed service level.Liaising with internal stakeholders, e., Call Centre, Claims, Fund management, new business, Finance etc. to resolve queries and positively influence the Clients expectation.The reconciliation of administered funds premiums, surcharges, and savings to statement balance.Allocations to be done within 1-2 days of payment being receipted.All interactions with customers must be carried out courteously.Credit control process & scheme rules to be adhered toInvestigating variances & discrepancies.Process necessary adjustments and journals.Ensuring that the rules of the fund are applied consistently.Any other duties as requested by management.Answer client queries telephonically orMaintenance and management of group and contract membership.
Competencies	ProfessionalSense of urgencyStress toleranceExcellent Communication Skills(verbal and written)Good time management skillsPlanning and organizingInitiative and pro-activeAnalytical thinkingPeople skillsAccountabilitySelf-motivatedGood interpersonal skillsExcellent problem solving skillsAbility to work under pressureAbility to meet deadlinesResults OrientedTelephone etiquetteStrong Customer service ethic
Enquiries	Zinhle.Madlala@momentum.co.za

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All the best with your applications.