Quality Assurer (Medical Claims) needed at FNB South Africa

Job Description

• To facilitate quality delivery and ensure adherence to quality standards across various business segments.
• To ensure implementation of identified quality methodologies and improvement initiatives.
• Facilitate quality delivery across the various teams.
• Monitor quality adherence and compliance to quality standards.
• Ensure implementation of identified quality methodologies and improvement initiatives.
• Deploy the quality management tools.
• Provide support and act as a feedback channel for quality issues.
• Communicate quality initiatives.
• Provide ongoing intelligence on customers and competitors using internal and external data sources i.e. monitor surveys etc.
• Offer input into market analysis and segmentation.
• Assist in aligning processes in the business and to ensure that this is in line with customers’ expectations.
• Identify possible risks in the area and come up with suitable action plans to ensure there are no loopholes in the process.

Requirements:

• Minimum Matric with experience in a similar role
• Minimum 2-3 years of experience in medical claims processing, quality assurance, or risk assessment
• Experience with retrenchment, disability, life cover, health, and critical illness claims is a strong advantage
• Knowledge of medical insurance policies, claims procedures, and regulatory requirements