Claims Auditor

Recruiter:

Fempower

Job Ref:

PT007271/BN

Date posted:

Tuesday, March 29, 2022

Location:

Centurion, South Africa

Salary:

Annually

JOB SUMMARY:
Our prestigious client in Financial Public Sector has an EE opportunity available for a Claims Auditor to be based in the Centurion area.

JOB DESCRIPTION:

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
Microsoft Office

KPAs:

Audit Planning – audit scoping, sample preparation on working papers and conducting opening meetings, audit planning memorandum
Manage SLA’s with third parties insofar as claims management in concerned Perform claims data analysis to identify non-compliance with SLA’s
Life Claims Administration
Calculating benefits payable
Claims assessing and validation including settlement, rejection and repair within set SLA
Investigate and report on fraudulent claims
Consults existing control systems to determine components that can be utilised/amended in the required control system
Implements control systems in accordance with policies, procedures and legal requirements.

Please note should you not receive a response within 7 days of applying, you may consider your application as being unsuccessful.

NB! This job is now closed. You can apply for other jobs by uploading your CV.

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