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  • Posted: Nov 21, 2024
    Deadline: Not specified
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  • 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 vehicles, buildings, vehicle contents) is excluded from cover.
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    Administrative Assistant x4

    Key Performance Areas

    Compliance administration.

    • Maintain up-to-date written documentation related to the departments business activities.
    • Ensure compliance to the policies and process standards. 
    • Keep abreast of internal standards and business goals to ensure adherence to sound internal control.

    Office coordination.  

    • Aid in the maintenance of correspondence, filing, telephonic queries and provide general administration support to the office.
    • Maintain strict confidentiality in all matters relating to the office.
    • Assist in making follow-ups on outstanding matters. 
    • Ensure all requests are handled and responded to within set timelines.
    • Engage and follow up with Processing Centers on outstanding matters 
    • Assist in ensuring the availability of stationery within the department.
    • Validate and verify information and documents submitted for accurate capturing and further handling.
    • Ensure the systems/registers used are kept up to date.
    • Check for duplicate documents, requests and queries and report on them.
    • Allocate reference numbers and accurately capture related documents on different systems.
    • Allocation of matters to responsible team members.
    • Draft and send out letters to all stakeholders as required. 

    Meeting support

    • Aid in arranging meetings on behalf of the department.
    •  Assist with taking and distributing minutes in accordance to set governance standards. 
    • Create and maintain a register to track matters outstanding.
    • Support in the maintenance of follow-up plan on meeting resolutions and matters outstanding.
    • Ensure confirmation of meetings and management of team diaries.
    • Schedule appointments with internal and external stakeholders as and when required.

    Document and Records Management.

    • Manage Administer the records management and filling processes in line with the RAF filling plan.
    • Ensure that the filing system is always up-to-date and functional.
    • Aid in the retrieval of information at all times as requested in the office. 
    • Ensure confidentiality of all documents under control and that documentation reaches the intended recipients.
    • Acknowledge the receipt of documentation, apply a file number allocation, record data onto the computer system and file appropriately.

    Qualifications and Experience  

    • Matric or Grade 12 certificate.  
    • Relevant 1 years’ experience in Administrative or similar environment.

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    Consultant: Pre-Assessment x6

    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 assesing 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 outcomes to the prospective claimants

    Quality assurance

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

    Administrative support

    • Document the acknowledged claims.
    • 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 and Experience  

    • Bachelor’s Degree/Advanced Diploma in a related qualification
    • Relevant 3 years’ experience in the Claims environment.

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    Consultant: Loss of Earnings: Adjudication

    Key Performance Areas

    Loss of earning adjudication

    • Confirm and record medical management recommendations.
    • Review the claim against the loss of earnings adjudication standards.
    • Check injury documents substantiating an ability to earn an income and make a determination.
    • Analyse the age, qualification level and skillset of the claimant to determine whether   the applicant qualifies for an LOE.
    • Make a determination on the whether the injured is able to earn income or not as well as whether the injured is major or minor.
    • Apply applicable case laws and Statutory limit to determine the LOE quantum.
    • Schedule the injured for medical assessment in line with the findings.
    • Make recommendations on an appropriate amount of money for pay out per case.

    Quality assurance

    • Adjucate the LOE product claim in line with the approved policy /SOP.
    • Participate in the consultations process on the implementation of programs and services.
    • Ensure that programs and services are implemented and maintained at the highest standards.
    • Implement the development and implementation of an unusual occurrence procedures.
    • Quality assure the loss of earning claims before they can be progressed to the next phase of the claims processing.

    Administrative support

    • Record and document proof affirnity.
    • 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 risk.
    • Provide ad hoc reports on process improvement initiatives.

    Stakeholder management

    • Maintain healthy relationships with all stakeholders.
    • Follow up and resolve all queries, following up and making recommendations on which corrective actions are appropriate.
    • 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 related qualification.

    Experience

    • Relevant 3 years’ experience in claims adjudication related environment.

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    Officer: Capital Payment

    Key Performance Areas

    To request of capital payments

    • Request payments in terms of block settlement agreements.
    • Request payments in respect of capital for claimants and/or their representatives.
    • Request time frames within which payments are to be effected in terms of the court order.
    • Prevent delays in requesting payments.
    • Identify fraudulent payments and advise Forensics.
    • Identify and record interim payments to prevent duplicate payments.
    • Compile a schedule of files where settled or capital payment is to be requested.
    • Check and prevent duplicate payments.
    • Follow up on delayed/pending payments.

    Provide customer services to clients of the RAF

    • Attend to queries from both internal and external stakeholders.
    • Provide advice and guidance to Claims sections in respect of duplicate or dummy files.
    • Identify referrals to Recourse and Recoveries.
    • Request termination of mandates where necessary before effecting payments.

    Collate and compile statistics as required

    • Record and maintain statistics on Payments requests.
    • Monitor and report on failed payments.
    • Keep daily stats of activities on work allocated and work to be done.
    • Submit daily, weekly and monthly stats as required.

    Render advisory responsibilities

    • Attend to queries from stakeholders pertaining to capital payments outstanding.
    • Provide feedback on payments to claims sections and attorneys.

    Provide office administrative services

    • Pre-screen files to ensure that they belong to the correct department of the RAF.
    • Validate that the correct banking details are loaded on the system prior to requesting payment.
    • Verify and validate that the payment is requested to the correct payee.
    • Receive and record files where capital payments are to be requested after concluding the validation process.
    • Updating the information on the files to correlate with the claims system iro claim number, link number, claimants and attorneys details.
    • Compile lists of finalized files to be forwarded to CAFS.
    • Request and return files from CAFS and claims when required.
    • Attend to queries.
    • Update the status and allocation of files on claims view system.
    • Maintain accurate records of files where capital payments are to be requested.
    • Keep records of movement of all files.  

    Qualifications and Experience

    • NQF 7 (Bachelor’s Degree or Advanced Diploma) related qualification to discipline.
    • Relevant 3 years’ experience in claims system, MVA procedures and knowledge of court processes environment.

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    Officer: Legal Administration X 6

    Key Performance Areas

    Legal Administration

    • Transcribe and proofread legal documents for settlement discussions.
    • Collate all the directives and update on the case file database.
    • Retrieval of information at all times as requested in the office.
    • Administer process relating to the arbitration of disputes between parties.
    • Briefing experts for purposes of administering the claims.
    • Administer hearings sessions to ensure that all parties and present information or evidence relative to claims is obtained.
    • Ensure confidentiality of all documents under control and that documentation reaches the intended recipients.
    • Follow-up on outstanding matters on behalf of the Legal Administration department in the office.
    • Document the proceedings and follow up on the action log relation to the settlement of the claims discussion.
    • File all settlement agreements.

    Block Settlements

    • Arrange meetings for block settlements.
    • Management of court documentation and filling.
    • Diarise and monitor court processes.
    • Narrate and provide clarity on the assessment and determination on the claims offer done.

    Reporting

    • Contribute to the preparation and submission of reports.
    • Report regularly and periodically perform necessary submissions as and when required to provide progress updates and/or inform management decisions.

    Stakeholder management.

    • Aid in proactive and progressive relationships with key stakeholders.
    • Deal with inquiries and requests for information from both internal and external stakeholders.

    Qualifications and Experience

    • Bachelors Degree in Law or equivalent.
    • Relevant 3 years’ experience in a Legal Administration related environment.

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    Consultant: Verification and Validation

    Key Performance Areas

    Verification and Validation.

    • Apply sound legal RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims.
    • Search for and apply relevant Case Law during verification and validation.
    • Determine the need to call in the injured for questioning in line with the RAF act.
    • Apply RAF procedures to validate the claims.
    • Assess duplicate claims to address mandates and minimise further processing of duplicate claims.
    • Examine and apply the prescription of rules at the claim and product level.
    • Verify data and information with relevant stakeholders.
    • Assess the validity of death benefits products to determine locus standi.

    Quality assurance

    • Maintain and update necessary reporting standards as per standard operating procedure.
    • Adequate and sound quality assurance.
    • Ensure that verification and validation are maintained at the highest standards.
    • Maintain the implementation of an unusual occurrence procedure.

    Administrative support

    • Document the acknowledge pre assessed claims.
    • 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.

    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.

    Reporting

    • Track and report against set objectives and targets.
    • Report on emerging risks.
    • Provide ad hoc reports on process improvement initiatives.

    Qualifications

    • Bachelor’s Degree/Advanced Diploma in a related qualification.

    Experience

    • Relevant 3 years’ experience in the Claims environment.

    Method of Application

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