Claims Assessors (X4 Posts) at The Department of Employment and Labour

REQUIREMENTS:

• Undergraduate qualification (NQF 6) as recognised by SAQA in Public Management/ Business Management / Operations management/ Management/ HRM/ Nursing/ Law/ LLB/ BCom / Finance/ Administration. 1- year functional experience in claims/ medical processing environment. Experience in claims processing environment will be an added advantage.
• Knowledge: Relevant regulations, laws and legislation, Treasury policies and PFMA regulations (legislative framework), claims handling, brand and customer oriented service delivery, relevant Compensation Fund policies, Public Service Act and Regulations, COID tariffs, Public Service charter, approved COID delegation, Promotion of Access to Information Act, Road Accident Fund (RAF) Act, Compensation for Occupational Injuries and Diseases Act (COID), Occupational Health and Safety Act (OHS, The Constitution of RSA.
• Skills: claim registration, tariffs administration, communication (written and verbal), analysis & interpreting information (data analysis), claim assessment/ settlement, post claims management and settlement, claims handling, claims verification and validation, monitoring & evaluation data gathering & analysis.

DUTIES:

• Adjudicate registered claims as per delegations' requirements, prepare complex claims. coordinate, capture and approve compensation benefits, handle claims enquiries and advocacy sessions, supervision of staff.