Manager: Claims Assurance

The Road Accident Fund’s mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.

Purpose of the Job: Reporting to the Senior Manager: Claims Assurance, the successful incumbent is responsible for the management of claims assurance by ensuring that there is uniformity, consistency and a standard compliance to the processing of claims and that all process that may lead the RAF into financial loss are identified and mitigated.

Key Performance Areas

Provide Leadership in the Claims Assurance Management

• Manage, monitor and ensure that claims assurance is effectively conducted and finalised in accordance with defined processes and procedures.
• Ensure all claims assurance requests are reviewed in a timely and correct manner.
• Ensure that complete diary notes are made on the Claims Assurance Management System daily.
• Ensure that proper records and systems are in place for all claims assurance requests received.
• Ensure that all claims assurance data (information and statistics) is captured into a database.
• Manage the collation of statistical and narrative reports on claims assurance caseload, progress, findings and recommendations for process improvements.
• Liaise with stakeholders, e.g. medical and other experts where applicable.

Provide Legal Advice

• Provide legal advice to the RAF on litigated claims and direct claims as and when required.
• Ensure that deviation from policy or process on claims is documented, reported and remediated.
• Ensure the implementation of training initiatives that optimise claims processing within the claims assurance department.

Policy Review and Implementation

• Contribute to the development and implementation of RAF policies, procedures and processes.
• Contribute to the development of Combined Assurance Framework, policies, procedures and guidelines; and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Keep up to date with effective policy and practice execution strategies.

Reporting

• Prepare regulation reports as and when required to provide progress, updates, make recommendations to inform management decisions.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in writting.

Stakeholder Management

• Support relationship building with internal and external stakeholders to facilitate performance of assurance engagements and exchange of knowledge on assurance best practice.
• Build relationship with internal and external stakeholders to facilitate performance of assurance engagements and identify appropriate areas of management support.
• Mantain relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
• Advise management on effective control measures, systems and fraud prevention measures.
• Represent the Fund in relevant external activities and events.

People Management

• Ensure the sourcing, development and retention of a high-performance team.
• Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
• Manage the implementation of human capital processes and procedures to control/ regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
• Ensure capacity development of staff and identify appropriate developmental opportunities.
• Manage performance of staff, mentor and couch staff.

Qualifications and Experience

• Bachelor’s degree in law or equivalent.
• Postgraduate in Law related qualification will be an added advantage.
• Qualification in legislative drafting advantageous
• Relevant 6 - 8 years’ experience within the Litigation environment of which 2 years must have been on a supervisory level/ management level/ area of expertise
• Business sector experience, preferably in a parastatal organisation would be advantageous
• Experience in a Legal Services field

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”.

The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.

Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful

Security Vetting shall be conducted on all prospective employees

It is the applicants’ responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.