Long-term Insurance Dispute Resolution Technical Lead

1 month ago


Johannesburg, South Africa The Recruitment Council Full time
Job Description: Long-term Insurance Dispute Resolution Technical Lead

Position Overview: The Long-term Insurance Dispute Resolution Technical Lead is a key role responsible for managing the dispute resolution process related to long-term insurance. This position involves representing the organization in interactions with various Ombudsman offices and regulatory bodies, ensuring compliance and effective handling of complaints.

Key Responsibilities:

  1. Dispute Management:

    • Oversee the recording and tracking of all complaints in the Client Relationship Management (CRM) database, ensuring all details are accurately documented for reference.
  2. Documentation Handling:

    • Ensure that all relevant documents, including physical copies and supporting materials, are properly uploaded and maintained for each complaint.
  3. Process Improvement:

    • Identify opportunities for enhancing client service and operational processes by analyzing service gaps and compliance issues, and recommending actionable solutions.
  4. Stakeholder Liaison:

    • Maintain communication with relevant business units to ensure timely and satisfactory responses to complaints, while monitoring the progress of each case.
  5. Risk Mitigation:

    • Proactively highlight any reputational or financial risks associated with service gaps or non-compliance, and develop strategies to address these issues.
  6. Regulatory Compliance:

    • Stay informed about changes in insurance legislation and industry standards, participating in ongoing education and training to maintain expertise.
  7. Knowledge Sharing:

    • Foster a culture of knowledge sharing by keeping the team updated on regulatory changes and best practices within the industry.
  8. Client Communication:

    • Ensure that clients receive timely updates and responses regarding their complaints, and provide necessary documentation to support claims processing.
  9. Relationship Building:

    • Establish and maintain effective relationships with both internal teams and external stakeholders through workshops and discussion forums.
  10. Reporting:

    • Respond promptly to inquiries from the Ombudsman and regulatory bodies, ensuring that all resolutions are completed within stipulated deadlines.

Requirements:

  • Essential Qualifications:

    • Matric / Grade 12 / National Senior Certificate
    • Advanced Diplomas/National 1st Degrees
  • Preferred Qualification:

    • Admitted Attorney
  • Preferred Certifications:

    • RE 5 Certification
  • Experience:

    • Minimum of 5 years experience as a Long-term Insurance Ombudsman Liaison specialist with a focus on dispute resolution.


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