Claims Quality Assurance Specialist

**THE JOB AT A GLANCE** As a Life Claims Assessor, you will be reporting to the Claims Manager: Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Effectively and efficiently perform the function of a Funeral...

**THE JOB AT A GLANCE** As a Life Claims Assessor, you will be reporting to the Partner Claims Specialist - Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Claims Adjudication**: - Verify claims captured for...

**THE JOB AT A GLANCE** As the Senior Claims Assessor, you will be reporting to the Team Leader: Senior Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Adjudicate on claims**: - Adjudicate claims...

**Job Advert Summary**: This role reports to the Team Manager Claims. Responsible for assessment and processing of short-term Sickness, Critical Illness and death claims. Quality assurance and authorization of claims for Junior and Intermediate claims assessors. Facilitate complex claims discussions within the team, conduct training and coaching to the team...

**Job Advert Summary**: This incumbent will be responsible for performing quality audits for internal operational processes in accordance with the HAD Internal QA procedures. In doing so the Quality Assurance Specialist provides assurance to Business Unit management that business operational processes have been followed, call scripts have been adhered to...

**Job Advert Summary**: Helloan exciting new opportunity has just become available in our **Hollard Insure **, in the **Operations** **area**. We are looking to recruit a **Complex Claims Specialist** **Role Objectives**: - Process all complex claims assigned, with a focus on all claims above Branch Mandate, within the set standards required by the...

**THE JOB AT A GLANCE** As a Payments Administrator, you will be responsible for assisting with the administration functions within the financial department for Claims, Commissions, Funeral and Pension payments. You will also be responsible for uploading payment reconciliations, reporting and actioning incoming queries. **WHAT WILL YOU DO?** **Payment...

**Purpose** To effectively and efficiently process and adjudicate Funeral Fund Claims, within the scope of the Funeral Fund policy rules and prevailing legislation. Also, to enhance and improve customer experience through effective assessment of claims and meeting the requirements and expectations of the role set out below. **Qualifications and Experience...

**THE JOB AT A GLANCE** **WHAT WILL YOU DO?** **Claims Administration**: - Acknowledgement of claims upfront - Communicate and articulate the claims process and requirements to the claimants and brokers, as pre-defined processes - Refer/channel claims to relevant departments - Gather information, send follow-ups and reminders on outstanding claims...

**Purpose** **Qualifications and Experience Required**: NQF Level 5 Higher Certificates and Advanced National (vocational) Certificate in business administration or commerce Additional insurance related qualifications or training will be advantageous. 2 - 3 years clerical, scanning and indexing experience required **Key Areas of...

**Job Advert Summary**: **Minimum Requirements**: **Key Responsibilities** - Quality assurance of claims documents received, as per the work instruction - Prepping of cases for the Medical Officer Committee - Updating of Masterfile for payments - DISA and PI payments - Sending out of PI claims correspondence, inclusive of attachments - Cancelling PI...

**Job Advert Summary**: Co-ordinate and oversee, manage negotiate and settle personal lines and commercial claims and account for the finalisation of the claim end-to-end. Delegate authority to manage the process and resolve any conflict by a negotiating, settlement, and finalisation functionality. Administer and validate claims correctly and efficiently...

**Job Advert Summary**: An exciting new **Digital Claims Adjustor **opportunity has just become available in our **Insure, Operations (Motor Claims Area).** **Role Objectives** Comprehensive desktop investigations are conducted within a digital environment. This ensures improved customer service, retention of customers and minimizing any claims leakage...

**THE JOB AT A GLANCE** Reporting administratively to the Chief Executive Officer (CEO) and functionally to the Chairman of the Risk Committee and Actuarial Committee, the incumbent will be responsible for strategically developing and implementing detailed Enterprise Risk Management, Regulatory Compliance Frameworks and Actuarial Frameworks incorporating...

**Job Advert Summary**: The Technical Specialist role will be responsible for testing function as well as supporting the Technical Specialist with the managing of deviations of a technical nature that impact service delivery. This role works strictly on a shift work basis including nightshift work. **Minimum Requirements**: **Qualification**: - Post Matric...

**THE JOB AT A GLANCE** To proactively prevent and detect suspicious and fraudulent activities in the funeral space preferably before claims are submitted, but also on reported claims, identify fraud trends and continuously develop process improvements and report on these trends to management. **WHAT WILL YOU DO?** Investigations: - Assist the...

**THE JOB AT A GLANCE** Reporting to the Head of Legal Operations, the incumbent will manage and attend to all third party (RAF) and non-RAF recoveries. The incumbent will contribute to the company's goals of recovering third party claims following losses suffered by RMA and in doing so influence the reduction of claims costs. **WHAT WILL YOU...

**THE JOB AT A GLANCE** Reporting to the Head of Legal Operations, the incumbent will manage and attend to all third party (RAF) and non-RAF recoveries. The incumbent will contribute to the company's goals of recovering third party claims following losses suffered by RMA and in doing so influence the reduction of claims costs. **WHAT WILL YOU...

**THE JOB AT A GLANCE** As a Payments Administrator, you will be responsible for assisting with the administration functions within the financial department for Claims, Commissions, Funeral and Pension payments. You will also be responsible for uploading payment reconciliations, reporting and actioning incoming queries. **WHAT WILL YOU DO?** **Payment...

**Job Advert Summary**: Helloan exciting new opportunity has just become available in our **Hollard Life Solutions, **in the **Business Assurance** area.** We are looking to recruit a **Ombudsman and OIA Case Specialist** **Role Objectives**: The primary purpose of the job is to receive and investigate complaints received directly from the National...