Consultant: Pre-Assessment at Road Accident Fund

Purpose of the Job:

The Consultant: Pre assessment is responsible for the pre assessment of prospective claims applications.

Key Performance Areas

Pre-Assessment of prospective claims.

• Record all the submitted documents for prospective claims.
• Determine the benefits and the products submitted based on the submitted documents.
• Assess the submitted documents to determine compliance as per defined processes and rules.
• Apply compliance and / lodgement rules in pre assessing the prospective claim.
• Identify duplicate claims and linked claims.
• Examine the prescription of lodgement and apply prescription rules.
• Verify mortality with Home Affairs.
• Communicate the assessment outcome to the prospective claimants.

Quality assurance.

• Ensure that pre assessment processes are implemented and maintained at the highest standard.
• Maintain the implementation an unusual occurrence procedures.

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 the updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications

• Bachelor’s Degree/Advanced Diploma) related qualification.

Experience

• Relevant 3 years’ experience in the Claims environment.

Competencies

Behavioural:

• Planning, Organising and Coordinating.
• Personal mastery.
• Judgement and Decision Making.
• Ethics and Values
• Client Service Orientation.
• Emotional Wisdom.
• Ethics and Governance.
• Customer orientation and customer focus.

Technical:

• Ability to differentiate different RAF Products.
• Knowledge of Motor vehicle At.
• 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 details.
• Natis and cross Check systems.