Consultant: Funeral Adjudication (X2)
East London, Eastern Cape, ZA
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.
Consultant: Funeral Adjudication (X2)
Note: This is a 24-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
- Judgement 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.”
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.