Claims Account Authorisers Manager

Federated Employers Mutual Assurance Company (RF) Proprietary Limited (FEM); Gauteng; On-site; ZAR 600,000 - 850,000; Full time

Job summary

A leading company in the financial sector is seeking a Claims Account Authorisers Manager to lead a team and ensure compliance and efficiency in claims processing. The successful candidate will play a key role in financial controls and risk management, enhancing operational efficiency within the organization. Candidates must have a strong background in medical claims and leadership skills to excel in this managerial position.

Benefits

Competitive total costs to company

Good benefits

Qualifications

• Must have at least 5 years of experience in medical claims or finance operations.
• Experience in regulated finance environment is beneficial.
• Proficiency in claims authorisations and COIDA regulations.

Responsibilities

• Oversee claims authorisation process ensuring compliance and accuracy.
• Lead and manage a team of Claims Account Authorisers.
• Monitor performance, provide coaching, and enhance operational processes.

Skills

Analytical skills

Leadership

Communication

Compliance understanding

Education

Matric

Registered nurse or medical qualification

Tools

Microsoft Excel

Job description

FEM is looking to appoint a Claims Account Authorisers Manager position within its Operational Finance Department, based at Head Office in Rosebank. This role reports to the Senior Operations Finance Manager and is responsible for overseeing the claims authorisation process, ensuring that all payments processed for claimants are compliant with COIDA, internal controls, and standard operating procedures.

The successful candidate will lead a team of Claims Account Authorisers and play a critical role in managing risk, strengthening financial controls, and ensuring high levels of accuracy and efficiency in claims-related payments.

The position will oversee and supervise a team of Claims Account Authorisers, ensuring efficient claim processing and compliance with internal controls, standard operating procedures (SOPs), COIDA legislation, and payment policies. The role involves reviewing and approving high-value and complex claims authorisations within delegated authority, while monitoring turnaround times, team performance, and the quality of outputs. Furthermore provide coaching, performance feedback, and training to the team, fostering continuous improvement and identifying opportunities to enhance controls. Additionally, collaborate with the Claims department, other operational teams, and Finance to resolve queries and maintain alignment. Manage preparations for internal and external audits, ensuring readiness and minimising audit, quality assurance (QA), and compliance findings.

Applicants must have successfully completed matric. Preferred qualifications and experience include being a registered nurse or holding another medical qualification, along with exposure to claims authorisations, COID tariffs, and claims systems. Additionally, experience in working within a regulated finance environment is highly beneficial, ensuring a strong understanding of compliance, financial controls, and operational requirements.

With at least five years of experience in medical claims, finance operations, or healthcare authorisations. Must have developed an in-depth understanding of COIDA regulations, financial controls, and medical claims procedures. Strong analytical, leadership, and communication skills to navigate complex operational challenges effectively. Additionally, be proficient in Microsoft Excel and familiar with various operational systems, to optimise processes and enhance efficiency to complete our requirements.

In exchange for the candidate’s successful services, FEM offers a competitive total cost to company remuneration with good benefits.

We have regional offices in Cape Town, Durban, and Johannesburg. This position will be based at the FEM Head office in Rosebank

Candidates are invited to submit a detailed CV by close of business on 17 June 2025.

Applications may not be considered if the minimum criteria of the position are not met. People with disabilities are welcome to apply. FEM promotes the principles of Employment Equity, and the appointment of this candidate is at FEM's sole discretion.