Claims Auditor
3 days ago
Gauteng
- ,
- Centurion
- Annually
- (Market related)
- Our prestigious client in Financial Public Sector has an EE opportunity available for a Claims Auditor to be based in the Centurion area.
- Education and Experience Requirements:
- Commercial Degree (BCom/Business Management/Economics/Law/Risk Management)
- 3-5 years experience in short term and/or Life insurance claims negotiation and handling
- 3-5 years experience in short term and/or Life general insurance
- 3-5 years experience in claims handling and Auditing
- 3-5 years claims auditing experience of SLA partners, UMA’s and Binder Holders
- Short term and/or life insurance claims negotiation and handling on an insurance operating system
- Microsoft Office
KPAs:
- Audit Planning - audit scoping, sample preparation on working papers and conducting opening meetings, audit planning memorandum
- Manage SLA’s with third parties insofar as claims management in concerned Perform claims data analysis to identify non-compliance with SLA’s
- Life Claims Administration
- Calculating benefits payable
- Claims assessing and validation including settlement, rejection and repair within set SLA
- Investigate and report on fraudulent claims
- Consults existing control systems to determine components that can be utilised/amended in the required control system
- Implements control systems in accordance with policies, procedures and legal requirements.
- For more information please contact:
- Babongile Ngwenya
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