Claims Auditor

JOB DESCRIPTION Audit Planning audit scoping, sample preparation on working papers and conducting opening meetings, audit planning memorandumImplementation testing scoped work and challenge control design and effectiveness, keep evidence and manage time accordinglyTechnical assessment of claim by checking the applicable cover, scheme and member details, eligibility, financial detailsAssess and confirm the eligibility, authenticity and validity of all evidence submitted by clientsAcknowledge all information received and let the client know who the assessor isClaims assessing and validation including settlement, rejection and repair within set SLALoss adjustment by correctly quantifying lossesProvides input into the development or changing of operations policies or drafting of new policies and/or claims control systems on request.Consults existing control systems to determine components that can be utilised/amended in the required control system.JOB REQUIREMENTSPreferred Minimum Education and ExperienceCommercial Degree (BCom/ Business Management/ Economics/ Law/ Risk Management)3-5 years experience in short term and/or Life insurance claims negotiation and handling3-5 years experience in short term and/or Life general insurance3-5 years experience in claims handling and Auditing3-5 years claims auditing experience of SLA partners, UMAs and Binder Holders
Johannesburg, GT, ZA