7 days ago
Job title : Consultant: General Damages
Job Location : Western Cape, Cape Town
Deadline : July 27, 2024
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Purpose of the Job:
The Consultant: General Damages Adjudication is responsible for or the processing of claimant applications with regards to general damages adjudication.
Key Performance Areas
General damages adjudication
- Review the claim against the general damages adjudication standards.
- Identify falsified general damages related injuries and report them.
- Confirm and record medical management recommendations.
- Apply relevant controls and tools to generate general damages offer, i.e,book of quantum.
- Calculate general damage product and make an offer.
- Process the offer to be communicated to the claimant following the appropriate channels.
Quality assurance
- Participate in the consultations process on the implementation of programs and services.
- Ensure that programs and services are implemented and maintained at the highest standards.
- Implement the development and implementation an unusual occurrence procedures.
Administrative support
- 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.
Reporting
- Track and report against set objectives and targets.
- Report on emerging riks.
- Provide ad hoc reports on process improvement initiatives.
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.
Qualifications and Experience
- Bachelor’s Degree/Advanced Diploma in Health Sciences related qualification to discipline.
Experience
- Relevant 3 years’ experience in a claims adjudication related environment.
Competencies
Behavioural:
- Planning, Organisation and coordinating.
- Personal mastery.
- Judgement and Decision Making
- Ethics and values.
- Client service orientation.
Technical:
- Claims assessment and settlement process and systems (including handling, general damages assessment and settlement)
- Medical case management.
- Complex problem identification, solving and decision making.
- Claims management processes and systems.
- Customer value proposition.
- Good financial management skills.
- Strong analytical capabilities.
- Knowledge of Motor Vehicle Accident legislation.
- PFMA knowledge.
How to Apply for this Offer
Interested and Qualified candidates should Click here to Apply Now
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