Senior Manager: Il Claims Administration

2 weeks ago


Pretoria, Gauteng, South Africa Atriplea Recruitment & Temps Full time

Pretoria Permanent R Senior Manager:
IL Claims Administration_Long Term InsuranceSector: InsuranceLocation: PretoriaSalary: R negotiable)Our client in the insurance sector is looking for a Claims Administrator to monitor the management of individual life claims administration

Duties:

  • Monitor management of claims administration on individual life policies
  • Design and develop standard operating procedures
  • Oversee the management of efficient and effective administration of claims
  • Align Branch Office procedures with Head Office procedures
  • Monitor processes and procedures for the detection of fraud activities on claims
  • Provide inputs to forensics, IT department and external fraud forum
  • Decide and discuss dispute claims
  • Decide on ex-gratia payments in agreement with Senior Executive Manager
  • Monitor payment turn-around time of finalized
  • Sign-off finalized approved claims payments
  • Co-ordinate complaints resolution and compliance
  • Provide inputs into strategy
  • Management of implementation of claims workflow and audits
  • Conduct claims audits at branches to comply with claims rules and procedures
  • Manage implementation of processes that are followed and completed for audits
  • Monitor completion and updates of loss/near loss register
  • Provide feedback on processes to auditors
  • Provide feedback to auditors on steps taken to ensure claims are paid correctly
  • Provide feedback to Risk Manager
  • Design and develop processes for unclaimed assets
  • Align unclaimed assets with claims rules and process
  • Obtain an external service provider to trace the policy holders
  • Attend the unclaimed asset committee meetings
  • Chair unclaimed assets committee and align with requirements

Report on IL Claims AdministrationRequirements:

Degree:
Risk Management/Business Management/relevant

  • RE1 & RE 5
  • Registration as a Key Individual
  • 60 or 120 credits on NQF level 5 (Depending on the date of appointment in the industry)
  • 5 Years' Experience in long term insurance claims
  • At least 5-8 years in ManagementSend your CV and latest pay slip to
    Recruitment and


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