Consultant: Pre-Assessment - JHB at Road Accident Fund

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.

Technical and behavioral competencies required

• Ability to differentiate different RAF Products
• Knowledge of Motor vehicle Act
• 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 detail.
• Planning, Organising and Coordinating
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation