Officer: Claims Investigation (x3)

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Job Opportunity: Officer: Claims Investigation (x3)

Position: Officer: Claims Investigation
Division: Operations
Company: Road Accident Fund (RAF)
Location: Johannesburg, Gauteng, South Africa
Employment Type: Fixed-Term Contract (12 months)
Reference No: 4888
Salary: R434,656.00 per annum
Closing Date: 17 January 2025


Job Purpose

The Officer: Claims Investigation is tasked with providing effective investigative support services for claims lodged against the Road Accident Fund, ensuring accuracy, compliance, and fraud prevention.


Key Responsibilities

1. Investigation and Assessment of Claims

  • Trace insured drivers and witnesses to consult and gather statements.
  • Draft proper sketch plans of accident scenes.
  • Capture clear photographs of accident scenes, individuals, vehicles, and injuries.
  • Obtain and verify affidavits from relevant parties (e.g., claimants, witnesses, employers).
  • Identify potential fraud or corruption and escalate to the Forensic Investigation Department.
  • Testify in court cases involving fraudulent claims.
  • Assist in securing witness presence for court proceedings.

2. Administrative Support

  • Validate supporting documents (e.g., employment and tax details, paternity/maternity documents).
  • Verify claimant and injured party details using Natis and Cross Check systems.
  • Verify vehicle ownership and details of other parties involved in accidents.
  • Perform quality checks on supporting documents to ensure claim validity.
  • Validate claims related to loss of earnings.
  • Provide progress reports as per service-level agreements.

3. Document and Records Management

  • Maintain an effective and organized filing system.
  • Ensure documents are correctly categorized and easily retrievable.
  • Administer records management in line with RAF’s filing plan.
  • Ensure confidentiality of documents and proper distribution of correspondence.
  • Retrieve archived files when needed.

4. Stakeholder Management

  • Advise claimants, witnesses, employers, and other stakeholders.
  • Address and resolve complaints related to claims assessments.
  • Maintain professional relationships with internal and external stakeholders.

Qualifications

  • Required: NQF Level 7 (Bachelor’s Degree or Advanced Diploma) in a relevant field.
  • Required: Valid Driver’s License.
  • Advantageous: Training as an investigator or certification as a fraud examiner.

Experience

  • At least 3 years of relevant experience in a similar environment.
  • Experience in merit and quantum investigations is advantageous.

Competencies

Behavioural Competencies

  • Planning, Organising, and Coordinating.
  • Personal Mastery and Decision Making.
  • Ethics and Values.
  • Client Service Orientation.

Technical Competencies

  • Proficiency in MS Word, Excel, and PowerPoint.
  • Strong administrative, planning, and organizational skills.
  • Ability to retrieve and assess required information.
  • Writing skills.
  • Basic understanding of SCM processes and financial concepts.

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