Key Performance Areas

Funeral adjudication

• Review the claim against the funeral adjudication standards
• Apply funeral benefit adjudication rules to determine quantum
• Generate funeral product offer using relevant offer template
• Obtain approval in line with DOA
• Research Analyse and review policies and laws relevant to assigned cases.
• After approval communicate the offer to the claimant through offer management

Quality Assurance

• Participate in the consultations process on the implementation of claims and related processes
• Ensure that claims and processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures
• Quality assure the funeral adjudication claims before they can be progressed to the phase of claims processing

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 risks
• Provide ad hoc reports on process improvement initiative

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 a related qualification
• Relevant 3 years’ experience in a claims adjudication related environment.