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Manager: Claims Administration

4 months ago

Menlyn Park, South Africa Assupol Full time

Description

Duties & Responsibilities:
**Manage claims administration: individual life and group scheme policies**
- Implement standard operating procedures for all claims received within the claims department.
- Management of efficient and effective administration of all claims at Head Office and branch level according to best practice
- Ensure quality claims assessment is rendered to all clients of Assupol
- Ensure written communication is done professionally and validate the correctness thereof
- Monitor and control claims processes and procedures
- Identify possible gaps in processes and procedures and provide solutions to management
- Oversee branch Office procedures are in line with Head Office procedures
- Implement processes and procedures for the detection of fraud activities on claims
- Provide inputs on dispute claims with Assupol Risk Committee
- Provide inputs on ex-gratia payments in agreement with Senior Manager: Claims
- Keep abreast with changes and updates of the industry
- Manage payment turn-around time of finalized claims (TCF)
- Sign-off and approve claims payments (TCF)
- Ensure clients are treated fairly the claims journey

**Manage performance and development of staff**
- Identify development areas for all staff in the department and provide guidance thereof
- Evaluation on performance of staff
- Ensure all new employees are inducted into the department

**Provide Reports to Senior Manager: IL Claims Administration**
- Oversee the maintaining of allocated registers within the department
- Compile reports for manager on claims activities
- Compile internal audit findings report with feedback and planning to Snr Manager on monthly basis
- Compile analysis report on claims scenarios to Snr manager on monthly basis

**Implementation of claims workflow and audits**
- Implement processes are followed and completed for audits taking place from Re Insurers as well as internal and external auditors
- Provide feedback on audit findings to Snr Manager
- Provide feedback to Snr Manager on steps taken to ensure claims processes are followed in claims administration

**Requirements**:
**Formal Education**:
Degree: B: 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)

**Experience**:
5 Years’ Experience in long term insurance claims; At least 2 years in Management

Work Level

Management

Job Type

Permanent

Salary

Market Related

EE Position

No

Location

Menlyn