Claim Processor Exempted Employers
The Department of Employment and Labour · Pretoria, Gauteng
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- Grade 12 Senior Certificate. Undergraduate qualification NQF level 6 as recognized by SAQA in Operations Management / Social Science / Public Administration / Public Management / Business Management / Business Administration / Administrative Management / Management / Financial Accounting / Cost and Management Accounting / Production Management / Internal Auditing / Human Resources Management / Nursing. None. Experience in a claims adjudication / social security / Insurance environment would be advantageous.
- Knowledge: Claims Administration. Claims Registration. Claims Investigations. Claims Management and Legal assessment and settlement. Claims Litigation. Claims Finalisation. Knowledge of Relevant Legislation Constitution, PFMA, PSRs, NTRs, ILO Conventions, PAIA, POPIA, OHSA, RAFA, Marriage Act, estate Law, UIA, Recognition of Customary Marriages Act, COIDA. Customer Service Batho-Pele. COIDA Tariffs. Human Anatomy/Biology. Medical terminology. Risk Awareness. Legislative Requirements: COIDA.
- Skills: Claims/Assessment /Settlement. Post claims management and settlement. Claims handling. Claim verification and validation. Conflict Management. Critical and Innovative Thinking. Communication. Quality Assurance. Service Delivery Innovation. Stakeholder Development & Relations.
DUTIES
- Provide Register and acknowledge claims. Prepare Compensation claims benefits.
- Handle claims enquiries. Render administrative duties