Membership and Contributions
- All membership related queries are handled here i.e. joining, resignation, cards issuance, account queries (payments and reconciliations)
- Claims processing and refund to providers and members
- Payment and remittance advice
- Authorisation of optical claims and adjudication
- Receiving foreign claims and conversion of all foreign claims including adjudicating foreign drugs, claim forms for onward transmission to the drugs department
- Attending to members with queries re-admissions
- Doing specialists and dental quotations
- Doing adjudication of all claims before they are forwarded for capturing
- Correcting drug tariffs
- Dealing with drug award queries and pharmacy award queries
- Prescription processing i.e. drugs bought cash and on medical aid with pre authorisation
- Capturing of drug claims
Day to day supplier expenditure payments
Queries and inquiries
- First port of call.
- Receiving MBRS/ Clients
- Directing client to the relevant section/ telephones to the relevant section.
- Dealing with claims queries from MBR and providers of service.
- Receiving cash and ensuring that cash is banked at the appropriate time.
- Maintaining the visibility of the society through creation of adverts.
- Presenting the society’s packages to interested organisations.
- Ensuring that the society grows in membership through innovative marketing strategies.