Reference: 42803197Road Accident Fund
Note: This is a 12-month, fixed-term contract position Purpose of the job: The Consultant: Funeral Adjudication is responsible for the processing and adjudication of funeral product claim. Key Performance Areas Funeral adjudication* Review the claim against the funeral adjudication standards.* Apply funeral benefit adjudication rules to determine quantum.* Generate funeral product offer using relevant offer template.* Obtain approval in line with DOA.* Research, analyse, and review policies and laws relevant to assigned cases.* After approval, communicate the offer to the claimant through offer management. Quality assurance* Participate in the consultations process on the implementation of claims and related processes.* Ensure that claims and processes are implemented and maintained to the highest standards.* Maintain the implementation an unusual occurrence procedures.* Quality assure the funeral adjudication claims before they can be progressed to the next phase of the claims processing. Administrative support* 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. Reporting* Track and report against set objectives and targets.* Report on emerging risks.* Provide ad hoc reports on process improvement initiatives. 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. Qualifications * Bachelor's Degree/Advanced Diploma in a related qualification. Experience* Relevant 3 years' experience in a claims adjudication related environment. Technical and behavioral competencies required* Claims management process/ processes and systems.* 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* Planning, Organising and Coordinating* Personal Mastery* Judgment and Decision Making* Ethics and Values* Client Service Orientation NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs."
Note: This is a 12-month, fixed-term contract position Purpose of the job: The Consultant: Funeral Adjudication is responsible for the processing and adjudication of funeral product claim. Key Performance Areas Funeral adjudication* Review the claim against the funeral adjudication standards.* Apply funeral benefit adjudication rules to determine quantum.* Generate funeral product offer using relevant offer template.* Obtain approval in line with DOA.* Research, analyse, and review policies and laws relevant to assigned cases.* After approval, communicate the offer to the claimant through offer management. Quality assurance* Participate in the consultations process on the implementation of claims and related processes.* Ensure that claims and processes are implemented and maintained to the highest standards.* Maintain the implementation an unusual occurrence procedures.* Quality assure the funeral adjudication claims before they can be progressed to the next phase of the claims processing. Administrative support* 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. Reporting* Track and report against set objectives and targets.* Report on emerging risks.* Provide ad hoc reports on process improvement initiatives. 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. Qualifications * Bachelor's Degree/Advanced Diploma in a related qualification. Experience* Relevant 3 years' experience in a claims adjudication related environment. Technical and behavioral competencies required* Claims management process/ processes and systems.* 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* Planning, Organising and Coordinating* Personal Mastery* Judgment and Decision Making* Ethics and Values* Client Service Orientation NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs."