Division: Claims
Reference No: 5198
Location: Johannesburg, Gauteng, ZA
Employment Type: Fixed Term Contract
Disability (EE targeted role): No
T.A.S.K Grade: 10
Job Posting Salary: R434,656.00
Purpose of the job: The Consultant: Verification and Validation is responsible for the verification and validation of registered claims.
Key Performance Areas
Verification and Validation.
- Apply sound legal RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims.
- Search for and apply relevant Case Law during verification and validation.
- Determine the need to call in the injured for questioning in line with the RAF act.
- Apply RAF procedures to validate the claims.
- Assess duplicate claims to address mandates and minimise further processing of duplicate claims.
- Examine and apply the prescription of rules at the claim and product level.
- Verify data and information with relevant stakeholders.
- Assess the validity of death benefits products to determine locus standi.
Quality Assurance
- Maintain and update necessary reporting standards as per standard operating procedure.
- Adequate and sound quality assurance.
- Ensure that verification and validation are maintained at the highest standards.
- Maintain the implementation of an unusual occurrence procedure.
Administrative Support
- Document the acknowledge pre assessed claims.
- Deal with/and respond to correspondence.
- Produce documents, briefing papers, reports, and presentations.
- Assist with typing and editing briefs, technical papers, letters to various parties, and memos.
Stakeholder Management
- Maintain healthy relationships with all stakeholders.
- Follow up and feedback to all stakeholders to keep them updated on the status of a query.
- Respond to queries within the predefined turnaround times.
Reporting
- Track and report against set objectives and targets.
- Report on emerging risks.
- Provide ad hoc reports on process improvement initiatives
Qualifications
- Bachelor’s Degree/ Advanced Diploma in a related qualification.
Experience
- Relevant 3 years’ experience in the claims enviroment.
Technical and behavioral competencies required
- Ability to differentiate different RAF Products
- Knowledge of Motor vehicle Act
- Complex problem identification, solving and decision making.
- Customer value proposition
- Good financial management skills
- Strong analytical capabilities
- Knowledge of Motor Vehicle Accident legislation
- PFMA knowledge
- Attention to detail.
- Planning, Organising and Coordinating
- Personal Mastery
- Judgement and Decision Making
- Ethics and Values
- Client Service Orientation