Claims Account Authorisers Manager

FEM; Johannesburg; On-site; ZAR 550,000 - 850,000; Full time

Job summary

FEM seeks a Claims Account Authorisers Manager for its Operational Finance Department in Johannesburg. The successful candidate will oversee claims processing and compliance, manage a team, and ensure financial accuracy. This role is pivotal in enhancing operational controls and managing risks, requiring a strong background in finance and healthcare authorisations.

Qualifications

• Matric completed; strong experience in medical claims and financing.
• At least 5 years in medical claims or finance operations.
• In-depth knowledge of COIDA regulations and compliance.

Responsibilities

• Oversee claims authorisation process ensuring compliance with COIDA and internal controls.
• Lead and coach a team of Claims Account Authorisers while ensuring efficiency.
• Manage audit preparations and maintain alignment between departments.

Skills

Analytical skills

Leadership

Communication

Proficiency in Microsoft Excel

Education

Matric

Registered nurse or medical qualification

Tools

Various operational systems

Job description

Job title : Claims Account Authorisers Manager

Job Location : Gauteng, Johannesburg Deadline : June 17, 2025 Quick Recommended Links

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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, 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, 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.