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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 Organisation requires the services of qualified individual within its East London Regional Office for the following position: -
 
THIS IS AN INTERNAL AND EXTERNAL RE-ADVERTISEMENT
 
POST CLAIM SETTLEMENT INTER
PCS 11032022 ELN
LOCATION: East London
CLOSING DATE & TIME: 3/22/2022 11:55 PM
 
Purpose of the Internship: The Road Accident Fund is committed to youth skills development by providing graduates with an opportunity to gain work experience. Applications are invited for a Post Claims Settlement Internship from unemployed graduates between the age of 18 and 35. The Internship programme will run for a period of eighteen (18) months.
 
Work based exposure may include the following.
  • Analysis of claimed invoices in correlation with available tariff structures and ICD 10 /CPT 4 codes
  • Requesting motivation for unreasonable accounts
  • Line by line analysis of claim items/service. Matching those appropriate tariffs/ ICD/CPT codes.
  • Flagging rejected items/services.
  • Recommendations to the department responsible for processing payments
  • Auditing medical claims and assisting in technical aspects of bill review
  • Ensure that accounts submitted to the Fund from service providers are valid in terms of RAF guidelines and the Road Accident Fund Act
  • Assess and monitor claims to curb over servicing or abuse and fraudulent claims
  • Ensuring that the accounts are paid timeously according to the service level agreements
  • Ensure that the services and treatments claimed are accident related/ (related to the accident under consideration
  • Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided
  • Manage future healthcare costs and improve efficiencies by analyzing trends in utilization of services
  • Formal assessment of medical necessity and appropriateness of procedures the will
be effective in curbing fraud and over servicing unreasonable demand of benefits from victims of road accidents.
  • Check and advise on tariffs used on accounts
  • Receive invoices and check payment request for accuracy and correctness.
　
Qualifications and Experience
  • Certified Grade 12/ NQF 4 level certificate
  • Certified copy of NQF 6/NQF 7 level Diploma / Advanced Diploma / Degree in the Medical Field of Anatomy and Physiology.
  • Certified copy of your ID
  • Certified copy Academic transcript
  • Your CV and motivational letter
 
Technical and behavioural competencies required
The successful candidate will be required to display the following competencies in this role:
  • Written and verbal communication skills
  • Interpersonal skills
  • Detail orientation
  • Desire and potential to learn
  • Self-motivated
  • Basic computer skills
  • Priortize tasks as needed
 
Road Accident Fund Values
  • Integrity,
  • Compassion,
  • Accountability,
  • Respect,
  • Excellence
 
Remuneration
Interns will be awarded a monthly stipend.
 
 
 
Closing date: 22 March 2022
 
APPLICATIONS CAN BE FORWARDED FOR ATTENTION OF THE RECRUITMENT OFFICER AT: elnpostclaimsinterns@raf.co.za
Kindly note NO hand delivered applications will be accepted.
 
INSTRUCTION TO PROSPECTIVE APPLICANTS
1. Indicate the reference number for the Internship you are applying for on the subject line.
2. Submit a short CV and a motivational letter as to why your application should be considered with a maximum of 3 pages, applications with no academic transcript will not be considered.
3. Applicants must be unemployed, or never employed in the field of the post and never participated in an internship programme in the relevant field of the post previously
4. The applicant must not have previously served as intern before.
5. Should it be found that the applicant previously served as an intern and did not disclose that info and it is discovered later, the applicant will be disqualified.
 
The Road Accident Fund subscribes to the principles of employment equity and preference will be given to groups who are underrepresented in terms of our Employment Equity Plan
 
Please note that the prospective employees will be subjected to security vetting
 
NB: Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful.
 
NB! ONLY THE FIRST 300 CV’S WILL BE CONSIDERED FOR THIS POSITION.


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The Organisation requires the services of a qualified individual within its Head Office on a 3 Year Fixed Term Contract for the following position:
 
THIS IS AN INTERNAL AND EXTERNAL ADVERTISEMENT
 
CLINICAL RESEARCHER: T.A.S.K LEVEL 14
: 21052021CRC
LOCATION: Centurion
CLOSING DATE & TIME: 3/22/2022 11:55 PM
 
Purpose of the Job: Reporting to the Medical Advisor, the successful incumbent will be accountable for working with clinical data for the collection, analysis, maintenance and use of quality data to support the development of evidence-based treatment protocols.
 
Key Performance Areas
Organise and Manage Health Information Data and Ensure its Quality, Accuracy, Accessibility and Security
  • Search and review data in adherence to requirements of the clinical research team.
  • Develop health-management information system (configuration and data structures) aligned to the objectives of the team.
  • Ensure rigor of literature accessed across all research projects.
 
　Maintenance, Collection and Analysis of Data.
  • Develop processes that ensure data accessibility, analysis and storage.
  • Define the data management framework compromising of research criteria, turn-around times for data requests and quality assurance.
  • Develop maintain project plans, specifications and documentation in line with SOP requirements.
 
　Teamwork and Stakeholder Relations.
  • Provide data management expertise within the team.
  • Devise processes and procedures to assist the team in data utilisation.
  • Provide regular training to staff on clinical topics within the team as well as within other teams in the organisation.
　
Administration and Report Writing
  • Compile monthly reports on data searches, utilisation, contribution to protocol.
  • Ensure processes are in place to have accurate and timeous information on databases and data management.
  • Run data cleaning and status reports.
 
Qualifications and Experience
  • Bachelor’s Degree or Advanced Diploma @ NQF 7 in Health Sciences (Nursing, Pharmacy related qualification to discipline).
  • Valid registration with the relevant Statutory body (SANC, SAPC, HPCSA, etc.).
  • Certification in evidence-based medicine and/or treatment protocol development will be an added advantage.
  • Relevant 5 -7 years’ experience in a Managed Healthcare environment or similar in data sourcing, collection and navigation of which 2 years must have been on supervisory level or area of expertise.
  • Experience working with treatment protocols and guidelines.
  • With experience working with medical database, navigating large data quantities and data outputs.
  • With experience working with ICD 10 codes, CPT codes and NAPPI codes Experience in Functional Capacity Evaluation and associated reports and tariffs applicable.
  • With experience working with coding systems (ICD10, CPT and NAPPI codes).
 
Technical and behavioural competencies required
  • Strategic capability and leadership.
  • Results orientation.
  • Business and financial acumen.
  • Brand and stakeholder orientation.
  • Organizational resilience.
  • Communication.
  • Team resilience.
  • Network and alliances.
  • Talent management.
  • Change management.
  • Computer literacy.
  • Display a basic understanding of evidence-based medicine.
  • Knowledge of medical terminology and legal aspects of health information.
  • Good understanding of data search engines and intelligent data extraction.
  • Understanding of data research principles.
  • Ensure quality, accuracy, accessibility and security of data.
  • Knowledge of health data standards.
  • Knowledge of "managed healthcare" or financial risk assessment principles (environment).
  • Knowledge of standards within the health industry.
  • Knowledge of the legislation governing RAF, policies and procedures.
  • Knowledge and understanding of the RABS Bill and its benefits.
  • Knowledge of the National Health Act, RAF Act and other health related legislation such as the Medical Scheme’s Act, etc.
 
Remuneration
Total cost to company applicable to this position is minimum R668 907.00 per annum, negotiable.
 
 
Closing date: 22 March 2022
 
Applications can be forwarded to the Recruitment Officer at Eco Glades; email address is Patiencem.recruitment@raf.co.za
 
INSTRUCTIONS TO PROSPECTIVE APPLICANTS
  1. Indicate the name and the reference number of the position you are applying for in the subject line.
  2. Do not submit copies of qualifications and ID as these will be requested from shortlisted candidates on the interview date.
  3. Submit a short CV with a maximum of 5 pages.
  4. Please indicate your current salary and salary expectations if considered for the position.
 
NB:
The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.
 
  • 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 Qualifications Authority (SAQA) and to provide proof of such.