Claims Auditor

3 days ago

Centurion, South Africa Fempower Personnel Full time

Gauteng

,

Centurion

(Market related)

Our prestigious client in the Financial Public Sector, has an EE opportunity available for a Claims Auditor in the Centurion area. This will be a fixed-term contract position for 6 months.
**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
- Claims function Quality assurance
- Microsoft Office

**KPAs**:

- Claims Auditing - audit planning and implementation
- Life Claims Administration
- Assess and confirm the eligibility, authenticity and validity of all evidence submitted by clients
- Assure capturing of claims are done accurately
- Calculating benefits payable
- Claims assessing and validation including settlement, rejection and repair within set SLA
- Reporting on all claims handles
- Provides input into the development or changing of operations policies or drafting of new policies and/or claims control systems on request
- Implements control systems in accordance with policies, procedures and legal requirements

For more information please contact:
Adri Bekker

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