Team Leader: Death Claims Assessor

6 months ago

Centurion, South Africa Momentum Life Full time

**Introduction**Role Purpose**Requirements**:

- Relevant Insurance/Financial services Industry knowledge and experience, applicable regulatory requirements, and legislations.
- Extensive knowledge of Section 37C of the Pension Funds Act. (essential).
- 5 years proven track record in a leadership role/people management (essential).
- MS Office Suite (Word, Excel)
- Relevant business-related qualification.

**Duties & Responsibilities**
- The overall lead of the team responsible for the Retirement Annuity death claims assessment team. The duties include managing, planning, monitoring, and reporting.
- Understand the regulatory framework, Pensions Fund Adjudicator related court decisions and/or determinations by regulatory bodies, governing bodies etc. that could impact the way claims are processed or handled.
- Analyse the assessment quality and make recommendations for improvement of assessors’ skills.
- Analyse and review existing processes and procedures in order to create, develop and introduce more effective and efficient ways of work.
- Guide team members with risk assessment techniques, medical knowledge and best practice guidelines.
- Assist with the quality audit of claims assessment and resolutions.
- Develop a high performing team by recommending training opportunities (formal and informal) aligned to assessor skills gaps, in order to enhance processes and increase effectiveness.
- Provide coaching and guidance to assessors to embed their skill, product knowledge, processes, and principles.
- Maintain and monitor team productivity and ensure that work is distributed and attended to within agreed SLA’s.
- Sign off assessments and approval of claims within the delegated authority level and required service levels aligned to product and policy requirements.
- Contribute to adhoc work and projects.
- Strong stakeholder management in respect of feedback to clients and communication to other stakeholders.
- High level client complaints, social media, complex and management escalations.
- To be responsible for the investigation of ombudsman and other claims under dispute, where assistance is required.
- Presentation of claims to the Board of Trustees and reports to the Sub-committees.
- Investigations of Pension Fund Adjudicator and other claims under dispute.
- Within direct scope of work, identify risk to prevent fraud and to deliver quality work.
- Contribute to a client service excellence culture which builds enduring relationships and allows team to provide exceptional client service.
- Build and maintain relationships with internal stakeholders responsible for the primary client and advisor interactions.
- Act in a way that allows for a positive work climate and culture with fellow employees.
- Assist with continuous improvement efforts by the identification of opportunities, cost reduction, improvement on the quality of claims decisions and systems enhancement.
- Providing insight, knowledge, assistance and provide testing support where necessary as part of the development and maintenance of all claims systems to improve quality and efficiency.
- Provide input in the review of all claims policies, practices, forms and documentation to ensure that our risk management standards are met and drafting new policies and practices where necessary.
- Assist with the delivery of accurate and timeous reporting, analysis and insights where required, and implementation of findings into the execution of claims assessment to improve the client experience and risk management.
- Incorporate internal assessment feedback into the enhancement of daily business processes and management operating systems.
- Build and maintain relationships with internal stakeholders responsible for the primary client and advisor interactions.

**Competencies**
- Business Acumen
- Client/ Stakeholder Commitment/management
- Drive for Results
- Leads Change and Innovation
- Motivating and Inspiring Team
- Communication skills
- Collaboration
- Impact and Influence
- Self-Awareness and Insight
- Diversity and Inclusiveness
- Adopting Practical Approaches
- Analytical
- Planning
- Judgement and Decision making
- Time Management
- Attention to Detail
- Following Procedures
- Managing Tasks and Setting goals
- Upholding Standards
- Strong Team player
- Cross team collaboration

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