Jobs at Absa Bank Limited

Job Summary

To support the Head of Medical Claims in the Medical Department by providing operational support in the Medical Department processes. To process and settle insurance claims in a fast, fair and courteous manner to ensure customer satisfaction, company profitability and good corporate image

Job Description

Claims vetting and approval (90%)

• Receiving and registering incoming claims.
• Claims adjudication.
• Analysing all patients claims (In terms of completeness and validity) and processing them for payment.
• Examining and confirming member benefits, entitlements and exclusions.
• Preparing member statements (on request) for clients regarding their policy benefit utilisation status.
• Preparing payment remittances and credit notes where applicable.
• Liaising with providers on claims queries .
• Prepare management reports.

Customer service, provider negotiations and reconciliation (10%)

• Handling customer queries (walk-in, phone & e-mail) in regards to claims and payments
• Assist in reconciliation and attending reconciliation meetings with the providers

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Job Summary

To engage with the business(First Assurance Company Ltd), to provide risk expertise in guiding and enabling them to execute their risk management processes in a manner consistent with the Absa Group Enterprise Risk Management Framework and related policies and standards

Job Description

Accountability: Risk Management Activities

• Assist in determining and reporting the BU risk profile.
• Assist business to understand the requirements of the ERMF (policies and standards). Aid business to identify the gaps between requirements and current status. Guide business to identify appropriate actions and activities to ensure compliance to requirements. Assist business to identify non-applicable requirements and provide guidance on the Dispensation and Waiver process.
• Assist the BU business in establishing and maintaining formal governance processes regarding the execution of the Enterprise Risk Management Framework and Key Risk processes
• Ensure business is trained on the usage of the applicable Risk management system to enable the recording of Risk Events, actions, RCSAs and Lessons Learnt.
• Continuously challenge the Risk and Control Assessment(RCA) process
• Prepare and speak to the BU risk profile at the BU Executive Risk Committee and Audit and Risk Committee.
• Ensure all aspects required by the Group Operational Risk team are attended to, at an appropriate quality and timelines.
• Engage with Internal and External Audit in the various audits within scope of responsibility.
• Be involved in the oversight of the implementation of new regulatory requirements as well as updated internal policies.
• Implement the risk management methodologies and practices to ensure compliance with current and international best practice principles.
• Implement robust risk analysis to ensure consistent risk measurement.
• Continually assess risks and assist to design control activities to respond to risks throughout the BU.
• Support the articulation of the Risk Appetite for all the relevant Principal Risks.
• Provide day to day technical risk advice to enable the business to better understand their risk profile.
• Review external risk events and assess, together with the business, whether we have appropriate internal mitigation in place.
• Scrutinize internal risk events and ensure that we meet the requirements of the risk events management standard (data elements align, lessons learnt completed – including root cause analysis and assessment of systemic impact
• Review and challenge the risk and control self-assessments and the associated structure and processes.
• Provide independent oversight and challenge on the governance and progress of major change programmes impacting or initiated/managed by the business.
• Support and challenge the BU Key Risk Owners on overall assessments and ratings.
• Agree tactical and strategic remediation plans and oversee and challenge implementation thereof against pre-determined and signed off outcomes.
• Engage BU to better understand emerging risks, and formulate the BU Risk response.
• Ensure that all risk reports are compiled and are of good quality and submitted timely as required.
• Establish clear and regular communication with business in creating awareness and understanding of risk management requirements including appropriate training.
• Ensure the BU has appropriate units of measure in place to monitor and manage their risk profile. Ensure that the indicators are monitored as appropriate.

Accountability: Outputs and deliverables

• Contribute to the development of the Risk Management strategy and be accountable for the implementation thereof to support the BU in the management of the Risk Profile.
• Be an active and accountable member of the Insurance Group Risk Management team to ensure alignment between Insurance Group Risk and to support the overall Risk Management strategy.
• Risk reporting as required.
• Pro – actively build and maintain relationships with business and maintain a contact point for any risk related matter.
• Make recommendations to business in relation to processes, procedures, policies and how to improve the risk environment.
• Facilitate regular workshops with business stakeholders to identify key risk associated with various elements of the business.
• Develop and maintain risk management practise with regards to the business and operational risk framework, establishing full alignment in risk and control identification and assessment. Ensure alignment with Absa Group as required.
• Assist business in the development of Key Risk indicators for measuring the utilization of risk against appetite.
• Be abreast of new risk (all principal risks), compliance or regulatory requirements.

Accountability: Risk Management

• Build and maintain relationships with the Business Units teams to ensure that risks are managed in accordance with the Risk framework.
• Maintain and develop awareness of risk management issues and changes across relevant Business Units & sub-units.
• Create a continuous relationship between risk and business in order to be aware of any new strategies or business changes that could potentially affect the risk profile of the business, and to understand and guide on any risk concerns identified.
• Understand the business concerns in order to be able to give sound advice on risk matters by working closely with the relevant Business, Risk, Governance & Control and Management Assurance teams.
• Build a strong relationship with assurance providers through driving and considering combined assurance activities.
• Provide adequate hand over in the event of passing over responsibility when on leave or leaving the department.
• Ensure a close working relationship with the Head of Risk of the Business Unit, which may not be the same person as line manager

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Job Summary

Exciting career opportunity at First Assurance Company Ltd. We are looking to hire an Assistant Manager - General Insurance Claims Department - Motor Section. To support the Head of Claims in the claims Business by providing operational support in the Claims Department processes. To process motor insurance claims in a fast, fair and courteous manner by ensuring that customer satisfaction, company profitability and good corporate image is maintained

Job Description

• Appoint and manage performance of service providers
• Process motor claims and ensure that claims are paid within the set TATs
• Resolving customers complaints and disputes swiftly and fairly to guarantee customer satisfaction.
• Approve claims settlement within agreed limits (signing authority)
• Preparing and presenting accurate and timely management reports.
• Examining loss assessment reports and recommending settlement or repudiation
• Assist and manage queries escalated by staff, brokers, clients or service providers to ensure timeous resolution.
• Liaise and visit brokers to build relationships
• Ensure that all the cost containment strategies in non-claims section are adhered to.
• Collaborate with underwriting department on areas or actions that may minimize loss es or risk improvement recommendations
• Escalate poor performing accounts to Head of claims for management
• Preparing claim payment vouchers for clients and service providers & credit notes
• Review claims reserves as per the set guidelines
• Attending to walk in clients and via telephone
• Manage performance of the direct reports
• Liaise with IRA on queries raised by the Regulator
• Ensure proof of payments are shared with the clients and the Service provider

Education

• Higher Diplomas: Business, Commerce and Management Studies (Required)