Note: This is a 12-month, fixed-term contract position Purpose of the job: The Consultant: Funeral Adjudication is responsible for the processing and adjudication of funeral product claim.
Key Performance Areas Funeral adjudication • Review the claim against the funeral adjudication standards.
• Apply funeral benefit adjudication rules to determine quantum.
• Generate funeral product offer using relevant offer template.
• Obtain approval in line with DOA.
• Research, analyse, and review policies and laws relevant to assigned cases.
• After approval, communicate the offer to the claimant through offer management.
Quality assurance • Participate in the consultations process on the implementation of claims and related processes.
• Ensure that claims and processes are implemented and maintained to the highest standards.
• Maintain the implementation an unusual occurrence procedures.
• Quality assure the funeral adjudication claims before they can be progressed to the next phase of the
claims processing.
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 a claims adjudication related environment.
Technical and behavioral competencies required • Claims management process/ processes and systems.
• 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
• Planning, Organising and Coordinating
• Personal Mastery
• Judgment and Decision Making
• Ethics and Values
• Client Service Orientation
NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs." Note: This is a 12-month, fixed-term contract position Purpose of the job: The Consultant: Funeral Adjudication is responsible for the processing and adjudication of funeral product claim.
Key Performance Areas Funeral adjudication • Review the claim against the funeral adjudication standards.
• Apply funeral benefit adjudication rules to determine quantum.
• Generate funeral product offer using relevant offer template.
• Obtain approval in line with DOA.
• Research, analyse, and review policies and laws relevant to assigned cases.
• After approval, communicate the offer to the claimant through offer management.
Quality assurance • Participate in the consultations process on the implementation of claims and related processes.
• Ensure that claims and processes are implemented and maintained to the highest standards.
• Maintain the implementation an unusual occurrence procedures.
• Quality assure the funeral adjudication claims before they can be progressed to the next phase of the
claims processing.
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 a claims adjudication related environment.
Technical and behavioral competencies required • Claims management process/ processes and systems.
• 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
• Planning, Organising and Coordinating
• Personal Mastery
• Judgment and Decision Making
• Ethics and Values
• Client Service Orientation
NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs."
