Ombudsman and Oia Case Specialist

**Job Advert Summary**:
Helloan exciting new opportunity has just become available in our **Hollard Life Solutions, **in the **Business Assurance** area.** We are looking to recruit a **Ombudsman and OIA Case Specialist**

**Role Objectives**:
The primary purpose of the job is to receive and investigate complaints received directly from the National Financial Ombudsman (NFO) office and other regulatory and addressing the allegations in the complaint in a response to the regulatory body as well as Adjudicator Matters. This position handles and manages Regulatory and NFO complaints across the Hollard Life Solutions This requires forward thinking and pro-active approaches resulting in exceptional case handling.

**Key Responsibilities**:

- Full and accurate investigation of all complaints received via the various Ombudsman bodies and Internal Adjudicator Office
Recommendation to review decisions where it is found that the complaint is valid.
- Liaising with departmental heads, and Internal Investigator on claims where further medical assistance or investigation as required by case.
- Management and administration of all NFO and FAIS Ombudsman complaints processes.
- Maintaining turnaround times in terms of Service Level agreements
- Recommendation to manager on proposed amendments to policy terms and claim forms as identified by trends
- Escalation of serious issues and concerns to manager
- Analyse monthly reports for anomalies
- Complication and submission of monthly report inclusive of stats to Manager by the 5th of each month. Report to include trends, anomalies and non-compliance to internal processes
- Assisting with special projects when called upon

**Required Knowledge and Experience**:

- 3 to 5 years’ experience in either customer services, claim or complaints environment.
- Experience with dealing with Ombudsman complaints.
- Previous operational/business experience understanding of business processes and procedures.
- Good understanding of legislative requirements in terms of market conduct/ and PPR
- Good understanding of Life Solutions business structure is an advantage
- Life Insurance Experience
- Organizational knowledge
- Legal knowledge and understanding
- Operational knowledge of relevant official authorities
- Broad medical knowledge would be an advantage- General business acumen Skills
- Integrity
- Analytical
- Good judgment
- Ability to prioritise
- Confidentiality
- Assertive
- Initiative
- Perceptive
- Persuasive
- Clear logical thinker
- Responsive to change
- Broad Life Solutions Insurance product knowledge
- Proactive - capable of identifying and initiating change
- Well organised
- Results and action orientated
- Deadline driven
- Ability to make decisions
- Attention to detail; and quality
- Able to work under pressure
- Strong Microsoft Office skills
- Strong Microsoft Excel skills
- Strong written and verbal skills

**Educational Requirements**:

- Relevant Diploma/Degree
- Certificate in long-term insurance, etc.
- 5 - 10 years’ experience in Life Insurance