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Post-Authorisation Advisor

2 weeks ago

Midrand, Gauteng, South Africa Sanlam Full time R250 000 - R500 000 per year

Who are we?
MiWay is a direct financial services company. We are passionate about service excellence, convenience and offering our clients superior value products. Our Vision is to be a world-class direct financial services business that offers a complete array of services under one convenient umbrella – all managed online. We are positive that with the right people on board, we will continue to grow and give our clients the freedom to do things their way – free from worry and most importantly at peace with all the "what-ifs" of the world. Company values that every employee subscribes to are: Energy, Freedom, Accountability and Attitude. The ideal candidate is one who has the courage to be bold and subscribes to MiWay's core values Do you have a positive attitude, love a challenge, treat your colleagues with respect and look for solutions, not problems? If yes, then MiWay is the place for you

What will you do?
The Post-Authorization Advisor is a specialized role focused on the financial and technical governance of approved Short-Term Insurance claims. The primary objective is to ensure that costs associated with authorized claims are managed effectively, fairly, and accurately. This involves auditing service provider invoices (e.g., motor repairers, building contractors) and validating financial loss calculations for Business Interruption claims. The role serves as a crucial control point to prevent financial leakage and ensure the integrity of the claims process.

What will make you successful in this role?
Minimum Qualification Required

  • Grade 12/Standard 10/NQF 4
  • National Diploma (NQF 6) or bachelor's degree in a relevant field (e.g., Finance, Risk Management, Law, Commerce)

Minimum Experience

  • Minimum of 3-5 years of experience within a claims environment in the Short-Term Insurance industry.
  • Direct experience in claims assessing, loss adjusting, claims validation, or a dedicated cost-containment role is essential.
  • Demonstrable experience negotiating with suppliers. Familiarity with industry quoting systems (e.g., Audatex for motor) and an understanding of building/repair costs. Experience reading financial statements is highly beneficial for BI.

Deliverables

  • Invoice and Quote Auditing: Scrutinize final invoices from service providers against authorized quotes, assessor reports, and company tariffs. For BI claims, audit financial statements and supporting documents to validate the quantum of the loss.
  • Cost Negotiation and Containment: Liaise and negotiate directly with service providers—including motor body repairers, building contractors, and specialist suppliers—to ensure costs are reasonable, customary, and aligned with agreed-upon rates.
  • Fraud, Waste, and Abuse (FWA) Detection: Identify and investigate potential instances of FWA by analyzing repair methodologies, supplier pricing, inflated labor hours, and suspicious patterns in BI calculations.
  • Provider Relationship Management: Build and maintain professional relationships with the approved service provider network to facilitate smooth communication, resolve disputes, and ensure compliance with company policies and Service Level Agreements (SLAs).
  • Scope Management: Monitor high-value or complex claims post-authorization to ensure the work completed does not extend beyond the original, authorized scope without proper justification and approval.
  • Reporting and Analysis: Generate regular reports on cost savings, provider performance, identified FWA trends, and negotiation outcomes to inform claims strategy.

Competencies Required

  • Analytical and Investigative Skills - Exceptional ability to analyze complex documents (quotes, invoices, financial statements), identify discrepancies, and investigate the root cause of inconsistencies.
  • Negotiation and Influence - Strong negotiation and conflict resolution abilities, capable of achieving cost-effective outcomes while maintaining professional provider relationships.
  • Meticulous Attention to Detail - Rigorous focus on accuracy when reviewing line items, part numbers, labor rates, and financial calculations to prevent overpayments.
  • Technical and Financial Acumen - A strong understanding of the technical aspects of motor/property repair and the ability to interpret financial documents for BI claims.
  • Assertive Communication - Clear, assertive, and professional communication skills (both written and verbal) to effectively query and challenge service providers on their costing and calculations.

Knowledge And Skills
Claims administration

Claims settlements

Payment approval and rejections

Operate within claims guidelines and compliance

Personal Attributes
Self-development - Contributing independently

Decision quality - Contributing independently

Plans and aligns - Contributing independently

Manages conflict - Contributing independently

Build a successful career with us
We're all about building strong, lasting relationships with our employees. We know that you have hopes for your future – your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realise their worth. Through its five business clusters – Sanlam Fintech, Sanlam Life and Savings, Sanlam Investment Group, Sanlam Allianz, Santam, as well as MiWay and the Group Office – the group provides many opportunities for growth and development.

Core Competencies
Cultivates innovation - Contributing independently

Customer focus - Contributing independently

Drives results - Contributing independently

Collaborates - Contributing independently

Being resilient - Contributing independently

Turnaround time
The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers.
Deadline to apply: 05 November 2025.
Our commitment to transformation
At MiWay we believe in cultivating a positive and dynamic working environment that gives you freedom and opportunity to succeed. MiWay is committed to transformation and embracing diversity. This is what drives us to achieve a multicultural workplace with employment equity as a key goal to create an inclusive workforce, reflective of the demographics of our society.