Claims Audit Officer – Pretoria (Fixed‑Term)

About the role

The Claims Audit Officer will conduct thorough audits of backlog claims to verify status, validate information, and determine the appropriate next steps. This is a two‑year fixed‑term position based in Pretoria, offering a structured environment for experienced quality‑assurance professionals.

Key responsibilities

• Validate merits and liability status, ensuring documentation is complete and recommending referrals to the appropriate workstreams.
• Review litigation status, confirm summons details, and advise on referrals to the litigation stream.
• Assess medical evaluations, general damages, and HPCSA records, directing files for further medical review when needed.
• Evaluate settlement readiness by confirming earnings information, expert reports, and education details, and flag files for actuarial assessment.
• Maintain accurate records of all audit findings and recommendations.

Required profile

• Bachelor’s degree or Advanced Diploma in Public Administration, Business Management, Quality Assurance, Compliance, or a related legal field.
• At least three years of quality‑assurance experience within a claims administration environment.

Required skills

What we offer

• Monthly salary of R36 000.
• Two‑year fixed‑term contract.