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ROAD ACCIDENT FUND (RAF) - SENIOR CLAIMS SPECIALIST X3
ROAD ACCIDENT FUND (RAF)
The Road Accident Fund's mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads
The Organization requires the services of qualified individuals within its Head Office on a Three (3) Year Fixed Term Contract for the following position:-
THIS IS AN INTERNAL AND EXTERNAL ADVERTISEMENT
SENIOR CLAIMS SPECIALIST: T.A.S.K GRADE 18 X3
05062021SCS
LOCATION: Pretoria
CLOSING DATE & TIME: 6/15/2021 11:55 PM
Purpose of the Job: The SENIOR CLAIMS SPECIALIST is accountable to oversee effective and efficient administration of all claims processes and systems within the RAF to deliver a high level of customer satisfaction. The role is also expected to drive implementation of the business operating model across the RAF processing centres.
Key Performance Areas
Claims Administration
- Establish and maintain appropriate systems to perform claims processing, medical administration and other claims related functions.
- Drive the provision of sound claims administration support to ensure a smooth claims experience for the claimants.
- Manage the implementation of automated processes of direct and indirect claims handling procedures and risk management processes that will enable a smooth claims process and foster transparency for the end user.
- Ensure that claims merits are thoroughly assessed and determination is based on accurate information.
- Liaise with other departments to identify improvements in claims process and procedure.
- Lead the effective and efficient provisioning of actuarial support and advice to the RAF business.
- Manage the implementation of a successful claims mediation process to minimize litigation of a claim.
- Ensure claims activities at a high level, comply with organisational requirements for quality management, legal stipulations, and general duty of care.
- Ensure claims are measured against operational risk systems and processes to govern threshold breaches.
- Contribute in the business strategies for RAF products and services.
Claims Optimisation
- Drive standardisation and re-engineering of current claims processes to enable them for process automation, digital initiatives, system deployments and new processes in line with new operating model.
- Improve operational efficiencies and identify opportunities for reducing operational costs
- Promote and develop a continuous improvement culture for claims processes across the RAF.
- Develop sound and quality reports for all relevant Committees for the RAF.
- Ensure data integrity across the merits department and consistency with other sources.
- Ensure monthly and quarterly claims related reports are created with an appropriate supporting analysis to identify any matters important for external commentary and for internal understanding of performance.
- Foster the use of business dashboards and reports that can be viewed by multiple stakeholders.
- Prepare and present management information and reports as required.
- Establish and maintain constructive and effective internal and external relationships with all key stakeholders and partners to ensure achievement of business objective.
- Develop and maintain ways of work with other functional areas to ensure a coordinated approach in delivering business initiatives and requirements.
- Build and maintain healthy and transparent relationships and rapport with internal and external stakeholders.
- Foster and advocate claims continuous improvement through coaching and applying problem solving tools and philosophies across the RAF.
- Provide sound advice on all escalated claims process and system related queries.
People Management
- Encourage an open culture for the continuous improvement of a high performance culture.
- Ensure proper planning and allocation of consistent workload within the business unit.
- Monitor performance of teams against planned activities.
- Identify and ensure sufficient training and development of employees within the business unit.
- Ensure that good employee's relations are maintained.
- Provide ongoing support and coaching for employees.
- Ensure that all employees have entered into performance contracts/agreements within the business unit.
- Conduct periodic employee's performance reviews and assessments.
Qualifications and Experience
- NQF 7 (Bachelor Degree) related qualification.
- Business qualification advantageous.
- Relevant 8-10 years' experience in the claims administration environment of which 3 (three) years must have been on management level.
- Strategic capability and leadership
- Results orientation
- Business and financial acumen
- Brand and stakeholder orientation
- Organisational resilience
- Communication
- Resilient
- Network and alliances
- Inspire commitment
- Talent management
- Change management
- Knowledge of claims management systems processes and administration.
- Data & analytical, communication, leadership, managerial and organizational skills.
- Skilled in critical thinking, creativity in resolving unique and challenging business problems.
- Ability to do long-term planning, to create and manage budgets.
- Innovative
- Verbal and Communication skills.
- MVA legislation knowledge or Insurance claims administration advantageous
- Integrity
- Compassion
- Accountability
- Respect
- Excellence
Remuneration
Total cost to company applicable to this position is market-related
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"
Closing date: 15 June 2021
Applications can be forwarded to the Recruitment Officer at Eco Glades; email address is Thembi.recruitment@raf.co.za OR hand delivered at 420 Witch-Hazel Avenue, Eco Glades 2, Centurion.
INSTRUCTION TO PROSPECTIVE APPLICANTS
- Indicate the name and the reference number for the position you are applying for on the subject line
- Do not submit copies of qualifications and ID as these will be requested from shortlisted candidates on the interview date
- Submit a short CV with a maximum of 5 pages
- Please indicate your current salary and salary expectations if considered for the position.
NB: Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful.
Security Vetting shall be conducted on all prospective employees
It is the applicants' responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.