Claims Examiner: Pre-Assessment Specialist

1 week ago


Durban, KwaZulu-Natal, South Africa Road Accident Fund Full time

We are seeking a skilled Claims Examiner to join our team at the Road Accident Fund. This is an exciting opportunity for a motivated individual to work in a dynamic environment and contribute to the success of our organization.

Job Description

The successful candidate will be responsible for conducting thorough pre-assessments of prospective claims, ensuring compliance with defined processes and rules. Key responsibilities include:

  • Determining benefits and products submitted based on documentation;
  • Assessing documents for compliance and applying relevant rules;
  • Identifying duplicate and linked claims;
  • Examining lodgement prescriptions and applying rules;
  • Verifying mortality records with Home Affairs;
  • Communicating assessment outcomes to claimants;

In addition to pre-assessment duties, the successful candidate will also be responsible for maintaining quality assurance standards, providing administrative support, tracking and reporting objectives, and managing stakeholder relationships.

Requirements

To be successful in this role, you will require a Bachelor's Degree or Advanced Diploma in a related field, along with 3 years' experience in the claims environment. Relevant insurance experience is highly desirable.

The ideal candidate will possess excellent analytical and communication skills, with the ability to work effectively in a fast-paced environment. If you are a detail-oriented professional with a passion for claims examination, we encourage you to apply for this exciting opportunity.

About the Role

This full-time position offers a competitive salary range of R350,000 - R450,000 per annum, commensurate with experience. The successful candidate will also have access to ongoing training and development opportunities to enhance their skills and knowledge.



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