The Road Accident Fund is a state insurer established by statute, it provides insurance cover to all drivers of motor vehicles in South Africa in respect of liability incurred or damage caused as a result of a traffic collision. Liability incurred in relation to property damage (such as damage to ve... read morehicles, buildings, vehicle contents) is excluded from cover.
Key Performance Areas
Management of claims payment process
Verify and approve claims payments in line with DOA by confirming the accuracy, validity ,completeness and existence of a payment by
Key Performance Areas
Policy review and implementation
Contribute to the development and implementation of departmental policy, procedures, and processes.
Keep up to date with effective pol
Key Performance Areas
ICT Relationship Management
Maintain relationship between ICT and internal and external partners (business units, service providers).
Drive Service Level Agreement (SL
Key Performance Areas
Develop and implement departmental policies, procedures and operational plans.
Provide assistance to Senior Claims Manager in formulating and implementing strategic dire
Key Performance Areas
Coordinate Processes Related to the Implementation of CSR Initiatives
Ensure that governance documents are kept up to date Coordinate the implementation of CSR programme
Key Performance Areas
Provision of Contract Management Support to the Organisation
Draft and vet procurement and/or other commercial contracts.
Monitor and report on the status of contracts
Key Performance Areas
Policy Review and Implementation
Contribute to the development and implementation of departmental policy, procedures and processes.
Keep up to date with effective poli
Key Performance Areas
Audit & review medical bills.
Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes.
Requesting motivation for
Key Performance Areas
Process incoming / outgoing mail and mail batching
Receive, register and stamp incoming correspondence.
Hand documents for scanning.
Ensure efficient and timely deli
Key Performance Areas
Perform Duplicate and other system checks with regards to claims and payments
Check and verify that all data on the claims system is correct
Request files from CAFS wit
Medical Management
Conduct medical assessment and compile injury assessment reports.
Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the le
Key Performance Areas
Legal Administration
Transcribe and proof-read legal documents for settlement discussions.
Collate all the directives and update on the case file database.
Key Performance Areas
Field Case Management
Activate an undertaking certificate and compile a case management report
Conduct a home visit and educate the claimant on offerings of the undert
Key Performance Areas
Medical Management
Conduct medical assessment and compile injury assessment reports.
Conduct assessments and bill reviews on submitted claims, focusing on the appropri
Key Performance Areas
Policy Review and Implementation
Contribute to the development and implementation of departmental policy, procedures and processes.
Keep up to date with effectiv
Key Performance Areas
Policy Review and Implementation
Contribute to the development and implementation of departmental policy, procedures and processes.
Keep up to date with effectiv
Purpose of the Job:
Reporting to the Senior Manager: Facilities Management, the successful incumbent is accountable to manage the Business support function in ensuring that the Facili
Purpose of the job:
The Consultant: Medical Management is responsible to implemement the medical management activities, medical exception handling and providing administrati
