Consultant: Verification and Validation x2

4 days ago

Cape Town, South Africa Road Accident Fund Full time

NB: This is a 12 Month’s Fixed Term Contract Position

 

Purpose of the Job:  The Consultant: Verification and Validation is responsible for the verification and validation of registered claims

 

Key Performance Areas

 

Verification and Validation

  • Apply sound legal (RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims.
  • Search for and apply relevant Case Law when during verification and validation
  • Determine the need to call in the injured for questioning in line with the RAF act.
  • Apply RAF procedures to validate the claims.
  • Assess duplicate claims to address mandates and minimise further processing of duplicate claims
  • Examine and apply the prescription of rules at the claim and product level
  • Verify data and information with relevant stakeholders
  • Assess the validity of death benefits products to determine locus standi.

 

Quality assurance

  • Maintain and update necessary reporting standards as per standard operating procedure.
  • Ensure that verification and validation are maintained at the highest standards.
  • Maintain the implementation an unusual occurrence procedure.

 

Administrative support

  •  Document the acknowledge pre-assessed claims
  • Deal with/and respond to correspondence
  • Produce documents, briefing papers, reports, and presentations.
  • Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

 

Stakeholder management

  • Maintain healthy relationships with all stakeholders
  • Follow up and feedback to all stakeholders to keep them updated on the status of a query
  • Respond to queries within the predefined turnaround times 

 

Reporting

  • Track and report against set objectives and targets
  • Report on emerging risks
  • Provide ad hoc reports on process improvement initiatives.

 

Qualifications and Experience       

  • Bachelor’s degree/Advanced diploma in a related qualification.
  • Relevant 3 years’ experience in the Claims environment

 

Technical and behavioral competencies required

  • Planning. Organising and Coordinating
  • Personal Mastery
  • Judgement and Decision Making
  • Ethics and Values
  • Client Service Orientation
  • Ability to differentiate different RAF Products
  • Knowledge of Motor Vehicle Act
  • Complex problem identification, solving and decision making
  • Customer value proposition
  • Good financial management skills
  • Strong analytical capabilities
  • Knowledge of Motor Vehicle Accident legislation.
  • PFMA knowledge
  • Attention to details

 

Road Accident Fund Values

  • Integrity
  • Compassion
  • Accountability
  • Respect
  • Excellence
  • Empathy

 

NB: “RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs”


NB: This is a 12 Month’s Fixed Term Contract Position

 

Purpose of the Job:  The Consultant: Verification and Validation is responsible for the verification and validation of registered claims

 

 

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