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  • Posted: Jan 21, 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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    Consultant: Pre-Assessment X10

    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/ lodgment rules in pre-accessing the prospective claim.
    • Identify duplicate claims and linked claims.
    • Examine the prescription of lodgment 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

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

    Experience

    • Relevant 3 years’ experience in the claims environment.

    go to method of application »

    Consultant: Verification and Validation X10

    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 enviroment.

    go to method of application »

    Legal Secretary - High Court X3 Kimberley

    Key Performance Areas 

    Legal Secretarial Administration

    • Prepare court statements and forms that Attorneys will need in court.
    • Dictate Attorney’s audio files and written notes.
    • Transcribe and proofread legal documents.
    • Index and update pleadings and discovery binders.
    • Collect and deliver documents.
    • Supporting legal research for cases and communicating with vendors, experts, attorneys, opposing counsel and other staff.

    Standard, Process and Procedure Maintenance

    • Ensure a strategy framework is maintained by required standards
    • Keep abreast of internal standards and business goals to ensure adherence to sound internal control.
    • Provide administrative support to the strategy and reporting office by RAF policies and procedures

    Quality Assurance Activities

    • Maintain up-to-date written documentation and policies related to the organisation's business activities.

    Office Management

    • Mantain correspondence, filing, telephonic queries and provide general administration support to the office.
    • Maintain strict confidentiality in all matters relating to the office
    • Make follow-ups on outstanding matters on behalf of the Legal Services department in the office.
    • Ensure all office requests are handled and responded to within set timelines.
    • Ensure availability of stationery within the department.

    Meeting and Diary Management

    • Arrange meetings on behalf of the Legal Services Department.
    • Take minutes and distribute these in accordance to set governance standards. 
    • Mantain 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 Control

    • Ensure that the filing system is always up-to-date and functional.
    • Collate court rolls received from the Registrar for the responsible court divisions, update references and distribute to state attorneys
    • Manage 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. 
    • Collate all the court directives and update on the court directives database
    • Maintain status update and records of all high value foreign national records for re-insurance purposes and report regularly

    Qualifications and Experience

    • National Diploma in Business Administration/Law related qualification. 
    • Relevant 2 years' experience in a business/law administration related environment.

    go to method of application »

    Consultant: Legal Costs x11

    Key Performance Areas

    Legal cost management

    • Keep up-to-date wih all incoming claims.
    • Read and interpret claims.
    • Review claims to ensure no fradulant or contradictory claims are made.
    • Determine if a claim requires the services of an attorney.
    • Determine the actual fees due to an attorney for each case.
    • Ensure all payments to attorney’s are fair and reasonable.
    • Consult different service providers to understand where the organisation could save on legal fees..

    Quality assurance

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

    Administrative support

    • 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

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

    Experience

    • Relevant 3 years’ experience in an insurance, legal or accounting related environment.

    go to method of application »

    Consultant: Offer Management x8

    Key Performance Areas

    Offer Management

    • Quality assure the type of offer made.
    • Identify and correct any defects in consultation with the originator of the offer.
    • Provide recommendations to the manager and team leader on settlement offers.
    • Communicate approved offer.
    • Request payment to be made.

    Exeption Handling

    • Assess the basis of the rejected offer.
    • Make necessary adjustment on the initial offer and communicate.
    • Suspend the claim until the dispute is resolved.

    Quality assurance

    • Ensure that legal costing processes are implemented and maintained at the highest standards.
    • Maintain the implementation of an unusual occurrence procedures

    Administrative support

    • Document and upload offers on the system.
    • Adequate provision of administrative support.
    • 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

    • Bachelor’s Degree/Advanced Diploma in a Health Sciences or Law related qualification.

    Experience

    • Relevant 3 years’ experience in an insurance related environment.

    go to method of application »

    Consultant: Medical Management (x8)

    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.

    Method of Application

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