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  • Posted: Feb 4, 2025
    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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    RAF Attorney: High Court Port Elizabeth

    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 policy and practice execution strategies.

    Preparation and Research on Related Litigation Matters

    • Conduct research that will provide information in preparation for all matters for trial.
    • Consult with client departments/ representatives, and witnesses for instructions and documentation for cases to be presented in Court.
    • Draft pleadings to provide clear motivation/justification on a particular position about the case.

    Mediation Process

    • All required steps regarding the mediation process, as governed by the amendment to the rules of court, are to be taken.
    • Upon conclusion of the mediation, parties shall inform Registrar and all other parties by a notice that Mediation is completed.
    • Parties & Mediator must within 5 days of completion of mediation issue a joint minute indicating.

    Represent the Road Accident Fund on all third party claims related litigation matters

    • Attend court appearances in all allocated third-party litigation matters.
    • Ensure file administration from opening to the conclusion of a legal case including adherence to trial dates.
    • Handle appearances at courts, tribunals, mediation hearings and inquiries.
    • Coordinate administrative legal actions to ensure compliance.
    • Approve instructions to appoint and instruct expert witnesses.

    Settle non-litigious matters before they are set down for trial

    • Block consultation, early assessment of files, and early instructions to experts and assessors.
    • Approve requests to appoint and instruct assessors and expert witnesses. 
    • Recommend a settlement. 

    Provision of legal advice to RAF

    • Provide legal advice on arising legal matters and contracts.
    • Provide well-researched legal advice on matters impacting the organisation.
    • Conduct legal research and prepare legal opinions.

    Taxation

    • Deliver a full range of tax services in compliance with laws and regulations.
    • Build relationships and interact with clients to provide consulting and expertise in tax services.
    • Provide innovative tax planning and review complex income tax returns

    Reporting

    • Prepare and submit regulation reports as and when required to provide progress updates and/or inform management decisions.
    • Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
    • Develop functional reporting systems, for management, projects or performance reporting.
    • Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

    Stakeholder Management

    • Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively and progressively manage the relationships.
    • Manage relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
    • Communicate with all levels of stakeholder contact.

    People management

    • Ensure the sourcing, development and retention of a high-performance team.
    • Manage the recruitment of the operational workforce in line with employment equity targets.
    • Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
    • Manage the implementation of human capital processes and procedures to control/regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
    • Allocate, direct, motivate and evaluate subordinates to help them achieve their individual goals.

    Qualifications

    • Bachelor’s Degree in Law or equivalent.
    • Postgraduate in Law or equivalent.
    • Admission as an Attorney of the High Court or Advocate.
    • Right of appearance in the High Court.

    Experience

    • Relevant 5-7 years legal experience post-graduation or admission of which 2 years must have been in area of expertise (personal injury litigation)

    go to method of application »

    RAF Attorney: High Court East London

    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 policy and practice execution strategies.

    Preparation and Research on Related Litigation Matters

    • Conduct research that will provide information in preparation for all matters for trial.
    • Consult with client departments/ representatives, and witnesses for instructions and documentation for cases to be presented in Court.
    • Draft pleadings to provide clear motivation/justification on a particular position about the case.

    Mediation Process

    • All required steps regarding the mediation process, as governed by the amendment to the rules of court, are to be taken.
    • Upon conclusion of the mediation, parties shall inform Registrar and all other parties by a notice that Mediation is completed.
    • Parties & Mediator must within 5 days of completion of mediation issue a joint minute indicating.

    Represent the Road Accident Fund on all third party claims related litigation matters

    • Attend court appearances in all allocated third-party litigation matters.
    • Ensure file administration from opening to the conclusion of a legal case including adherence to trial dates.
    • Handle appearances at courts, tribunals, mediation hearings and inquiries.
    • Coordinate administrative legal actions to ensure compliance.
    • Approve instructions to appoint and instruct expert witnesses.

    Settle non-litigious matters before they are set down for trial

    • Block consultation, early assessment of files, and early instructions to experts and assessors.
    • Approve requests to appoint and instruct assessors and expert witnesses. 
    • Recommend a settlement. 

    Provision of legal advice to RAF

    • Provide legal advice on arising legal matters and contracts.
    • Provide well-researched legal advice on matters impacting the organisation.
    • Conduct legal research and prepare legal opinions.

    Taxation

    • Deliver a full range of tax services in compliance with laws and regulations.
    • Build relationships and interact with clients to provide consulting and expertise in tax services.
    • Provide innovative tax planning and review complex income tax returns

    Reporting

    • Prepare and submit regulation reports as and when required to provide progress updates and/or inform management decisions.
    • Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
    • Develop functional reporting systems, for management, projects or performance reporting.
    • Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

    Stakeholder Management

    • Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively and progressively manage the relationships.
    • Manage relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
    • Communicate with all levels of stakeholder contact.

    People management

    • Ensure the sourcing, development and retention of a high-performance team.
    • Manage the recruitment of the operational workforce in line with employment equity targets.
    • Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
    • Manage the implementation of human capital processes and procedures to control/regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
    • Allocate, direct, motivate and evaluate subordinates to help them achieve their individual goals.

    Qualifications

    • Bachelor’s Degree in Law or equivalent.
    • Postgraduate in Law or equivalent.
    • Admission as an Attorney of the High Court or Advocate.
    • Right of appearance in the High Court.

    Experience

    • Relevant 5-7 years legal experience post-graduation or admission of which 2 years must have been in area of expertise (personal injury litigation)

    go to method of application »

    Consultant: Medical Management - Durban

    Key Performance Areas

    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 length of stay, and quality of care.
    • Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
    • Pre authorise submitted claims aligned to RAF clinical guidelines including the RAF formularory, treatment protocols and related tarrifs.
    • Escalation of complex cases for multi disciplinary review and adjudication.
    • Participate in the consultations process on the implementation of medical claims processes.

    Exception Handling

    • Ensure the implementation and maintenance of a formal exception handling process within the medical management.
    • Maintain the documentation and regular updating of the exception handling process.
    • 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.
    • Produce documents, briefing papers, reports and presentations.

    Stakeholder Management

    • Deal with/and respond to correspondence.
    • 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 Health Sciences /Medical related qualification.
    • Registration with HPCSA/SANCA.

    Experience

    • Relevant 3 years’ experience in a Medical related environment.

    go to method of application »

    Senior Officer: Field Case Management x4 Durban

    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 undertaking and explain about the overall process to be followed
    • Conduct follow up assessments and make recommendations on claimants needs as per the assessment
    • Coordinate the referrals to service providers aligned to the claimants needs as per the undertaking certificate
    • Ensure successful integration of the claimant back to the family and educate the claimant and family on the condition of the claimant
    • Facilitate timely consultation with appropriate medical service providers
    • Provide vocational guidance after life changing event for client and possible back to work opportunities

    Rehabilitation Services

    • Monitor the rehabilitation of the claimant post discharge
    • Monitor the drug utilisation and application review therof
    • Assess the level of care giver and the financial implications /salary therof 
    • Determine claimant needs and facilitate reasonable recommendations for home and car modifications based on the nature of the claimant's medical condition 
    • Co-ordination of admission and request the necessary authorisations as per the caregiver SOP and guidelines
    • Co-ordinate and faciltate transfer to the hospital for admission
    • Facilitate the appointment of caregivers between the claimant and the caregiver, provide guidance on the process
    • Co-ordinate the monthly submission of time sheets for payment processing

    Facilitate the accuracy and effective submission of invoices

    • Ensure that accounts submitted to the fund from service providers are valid in terms of RAF guidelines and the Road Accident Fund Act
    • Assess and monitor claims invoices to curb over servicing or abuse and fraudulent claims 
    • Ensure that the accounts are paid timeously, according to service level agreements
    • Ensure that services and treatments claimed for are accident related (related to the accident under consideration)
    • Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided is invaluable in developing guidelines for clinical management

    Reporting

    • Compile and update case management reports for the injured.
    • Provide a report on patient care and ongoing rehabilitation.
    • Reporting on the service by service providers.

    Stakeholder management

    • Drive the stakeholder interaction needed to facilitate the level of care
    • Maintain relations with different levels of health specialst to enable smooth interactions 
    • Participate in the awareness of RAF case management services in the communities 
    • Communicate with all levels of stakeholders
    • Participate in relevant external RAF activities and events
    • Ongoing engagements with service providers

    Qualifications

    • Bachelor's Degree or Advanced Diploma in  Nursing/Allied Health Prefessions or related qualification
    • Registration with the relevant Health Professions Council.

    Experience

    • Relevant 4 years’ experience in the Medical environment.
    • Experience in Managed Healthcare environment.
    • Valid code 8 driving license.

    go to method of application »

    Officer: Legal Administration - JHB

    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.
    • 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 claim’s discussion.
    • File all settlement agreements.

    Block Settlements

    • Arrange meetings for block settlements.
    • Management of court documentation and filing.
    • 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

    • Bachelor's degree in law or equivalent.

    Experience

    • Relevant 3 years’ experience in a Legal Administration related environment.

    go to method of application »

    Consultant: Medical Management - Menlo Park

    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 length of stay and quality of care.
    • Incorporate tariffs, cost savings initiative recording and treatment protocol to ensure that all service providers adhere to the rules and the tariff as guided by the RAF and/or any that is considered reasonable.
    • Pre-authorise submitted claims aligned to RAF clinical guidelines including the RAF formulary treatment protocols and related tariffs.
    • Escalation of complex cases for multi-disciplinary review and adjudication.
    • Participate in the consultations process on the implementation of medical claims processes.

    Exception Handling

    • Ensure the implementation and maintenance of a formal exception handling process within the medical management.
    • Maintain the documentation and regular updating of the exception handling process.
    • 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.
    • Produce documents, briefing papers, reports and presentations.

    Stakeholder Management

    • Deal with/and respond to correspondence.
    • Maintain healthy relationships with all stakeholders.
    • Follow 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 and Experience

    • Bachelor’s Degree/Advanced Diploma in Health Sciences/Medical related qualification.
    • Registration with HPCSA/SANCA.
    • Relevant 3 years’ experience in A Medical related environment.

    go to method of application »

    Administrative Assistant - Menlo Park

    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 within specified time frame
    • Assist in the management of the ILS Professional Assistant’s trial diary
    • Assist the Professional Assistant with trial preparation
    • Administer and maintain effective and efficient movement of records

    Qualifications

    • NQF 4(Matric or Grade 12) qualification.

    Experience

    • Relevant 1 year working experience in a similar environment.

    go to method of application »

    Administrative Assistant (Document Services)

    Key Performance Areas

    Process incoming / outgoing mail and mail batching

    • Receive, register and stamp incoming correspondence.
    • Hand documents for scanning.
    • Ensure efficient and timely delivery of mail within the RAF.
    • Separate incoming documents and faxes and sort according to destination.
    • Ensure files, correspondence and all other documentation is filed according to established policy and procedure.
    • Prepare outgoing mail for posting.
    • Ensure that outgoing mail is correctly priced and franked.
    • Record details of all registered mail and Docex Tracker mail.
    • Declare monies received and capture in register
    • Prepare bulk mailing. 
    • Check addresses and ensure Docex is sent to Docex, Normal and Registered mail to the Post Office.

    Perform a range of correspondence Management responsibilities 

    • Perform scanning & indexing.
    • Check that all mail has been verified before scanning belongs to the Junior Officer Level or above.  
    • Ensure that the copying and binding machines are maintained in working order.
    • Monitor and make sure that requests for copying or binding are executed efficiently and timeously.
    • Ensure quality of copying and binding.
    • Belongs to the Junior Officer Level or above. Messenger’s responsibility.
    • Archiving assistant’s responsibility. 
    • Ensure that mail and files are validated and prepared before scanning. 
    • Sort documents according to document class and insert separator pages between classes.
    • Ensure that all scanned mail and files are indexed and successfully released to Share Point.
    • Receive, stamp, sort, identify, scan and capture writs and summons.
    • Check documents and contact attorneys for further information or reference numbers.
    • Capture documents in register.
    • Insure items if necessary.

    Perform Banking Indemnity Form (BIF) processing.

    • Capture and verify information recorded on the BIF.
    • Liaise with stakeholders. 
    • Contribute to Ensuring that claimants and suppliers are paid timeously by meeting turnaround times...
    • Ensure that critical timeframes is adhered to.
    • Minimize the risk of fraud exposure.
    • Adhere to BIF rules and SOP’s to ensure compliance

    Render maintenance of Correspondence Management Infrastructure, equipment’s and material

    • Report that all mailroom-related equipment is serviced and in good working condition at all times.
    • Report on the maintenance of the franking machine in terms of technical maintenance and the loading of money. Belongs to the Admin Officer or senior Officer Level.
    • Paste the registered mail tracking stickers. Belongs to the Admin officer or senior Officer Level.
    • Perform searches and or retrieve documents from Share Point / MOSS.
    • Highlight areas of problems and make recommendations to Line management.

    Required minimum education/training

    • NQF 4 (Matric or Grade 12) qualification.

    Required minimum work experience

    • Relevant 1 year experience in an administrative environment.

    go to method of application »

    Officer: Bill Review

    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 unreasonable accounts
    • Line by line analysis of claim items/service. Matching those appropriate tariffs/ ICD/CPT codes.
    • Flagging rejected items/services.
    • Recommendations to the department responsible for processing payments
    • Auditing medical claims and assisting in technical aspects of bill review
    • Ensure that accounts submitted to the Fund from service providers are valid in terms of RAF guidelines and the Road Accident Fund Act
    • Assess and monitor claims to curb over servicing or abuse and fraudulent claims.
    • Ensuring that the accounts are paid timeously according to the service level agreements.
    • Ensure that the services and treatments claimed are accident related/ (related to the accident under consideration
    • Reduce future healthcare cost and improve efficiencies by analyzing trends in injured person’s use of services.
    • Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided.
    • Manage future healthcare costs and improve efficiencies by analyzing trends in utilization of services.
    • Formal assessment of medical necessity and appropriateness of procedures the will be effective in curbing fraud and over servicing unreasonable demand of benefits from victims of road accidents.

    Promote good working relations with Stake Holders

    • Check and advise on tariffs used on accounts.
    • Provided training on new developments.

    Approve medical expenses in accordance with relevant DOA

    • Authorization in accordance with mandate
    • Inform service provider of payment decision.

    Assisting in technical aspects of bill review

    • Develop and manage relationships with department of health services, government dept and other key external stake holders.

    Check & approve Payments.

    • Receive invoices and check payment request for accuracy and correctness.

    Determine the level of care based on functional ability.

    • Analysis of medical data available e.g. Case Manager’s Reports, Clinical Records and Medico – Legal Reports

    Preauthorization of procedures

    • Analyse medical data to determine the need for the service.
    • Timeous assessment of urgent files e.g. Road Shows

    Qualifications and Experience

    • Bachelor’s Degree or Advanced Diploma in nursing/ Allied Health Professions or related qualification
    • Relevant 3 years’ experience in a medical field.
    • Registration with the relevant Health Professional Council

    Method of Application

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