Supervisor: Quality Assurance

2 weeks ago


Menlyn Park, South Africa Assupol Life Ltd. Full time

**Duties & Responsibilities**:
**Oversee Quality Assurance**
- Assist with implementation of quality management of the compilation of a quality strategy for claims
- Monitor processes annually to ensure the process applied is still valid and necessary (0% operation errors)
- Analyse and evaluate fraud statistics and report trends to claims management
- Monitor and correct all written communication to clients
- Monitor that department comply 100% with TCF outcome 6
- Report on the turnaround time of all claims finalized within set time
- Assist in the identification of problem areas within the claims department and report to claims management

**Forensic Investigations internal and external**
- Oversee report of suspicious activities, internal and external immediately to claims management
- Report on any exceptions found in claims data
- Liaise with external and external parties relating to forensic investigation
- Oversee XTND and Forensic report and provide summary to claims management
- Assist in all flagging on policies with suspicious activities
- Report concerns raised by internal or external parties relating to suspicious activities

**Compiling of information**
- Oversee the gathering, compiling and dissemination of all reports within the Claims space.
- Analyse reports and recommend strategies based on the reports circulated.
- Oversee compilation daily, weekly and monthly reports for claims management - )0% missing of deadlines
- In conjunction with claims management develop new reports (while working with Claims management to establish reporting requirements to validate/enhance the performance of these reports).
- Report override approvals of payments by managers
- Report progress on recoveries made on incorrect payments
- Report any losses/risks occurred
- Analyse delays identified in the finalization of claims
- Analyse delays on the finalization of outstanding claims
- Advise claims management when notes was not made on AIMS according to policy and procedure
- Exceptions found in claims data

**Audit and Risk requirements**
- Monitor and report 100% compliance with all requirements per deadlines as per audit (internal and external) findings
- Monitor the awareness of risk issues and compliance with risk registers within the Department
- Assist with audit proceedings and compile report

**Managing smooth operation of the department/training**
- Oversee GRMS to ensure all e mails received was timeously attended to
- Conduct training to new employees and sales representatives in accordance with Talent Development initiatives and training plan
- Facilitate training and development needs of staff
- Appraise employees in conjunction with claims management
- Oversee compliance with HR Policies and Procedure e.g. Leave, Performance reviews, etc of team

**Formal Education**:
Quality Diploma/Degree/relevant

RE1 & RE 5 (Advantage)

60 or 120 credits on NQF level 5 Wealth Management (Depending on the date of appointment in the industry) (Advantage)

**Experience**:
3 Years’ Experience in long term insurance claims



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