Funeral Claims Manager

14 hours ago


Sandton, South Africa Moving Heads Personnel Full time

**Funeral Claims Manager**

**Sandton**

Assist in proactively managing claims at the individual and portfolio level while ensuring high quality and achieving high levels of satisfaction for the members, claimants, dependents, and Service Providers. Assisting in ensuring that the Funeral and Group Risk Claims teams achieve their operational strategic goals through keeping performance to the highest standards, deliver excellent customer service, while complying with all relevant legislations and all company policies and procedures. Lead and supervise the effective and efficient adjudication of Group Risk and Funeral claims.
- Manage claims and administration costs
- Proactively manage funeral claims from notification to closure
- Proactively supervise the proper adjudication of claims
- Handle complex and fraudulent claims
- Ensure that all payments are correct and in accordance with company and legislative requirements
- Feedback claims trends, developments and their potential impact on claims costs
- Ensure that claims are assessed and/or reviewed for TTD, Lump Sum or Pension
- Ensure that all Technical Instructions, Standard operating procedures were considered, and claims are adjudicated accordingly
- Ensure that all Life Claims SOP’s, processes, and system enhancements are done to align to new product and/ or enhancements
- Ensure that Funeral and Death claims are prioritised as per agreed SLA Customer Focus and Stakeholder Management
- Identify issues and claims trends in the portfolio, advice Senior Management with recommendation for appropriate and corrective action
- Handling and resolving client inquiries related to service delivery
- Ensure that customer satisfaction targets are cascaded to all customer facing roles, and assessed monthly
- Reviewing trends, variances and making changes to improve performance
- Ensuring that systems are used effectively to improve accuracy and minimise errors
- Handling complex complaints or difficult customers
- Develop interdepartmental Service Level Agreements
- Identify key risks indicators and establish mitigating controls
- To ensure that expenditure is incurred within the limits of the sanctioned budget
- Ensure optimal liaison with stakeholders including but not limited to employers, employees
- To ensure that new risks are identified, reported to risk for monitoring and to ensure that mitigating controls are implemented Compliance
- Management of and participation in Strategic or Operational Projects identified by the Company, within a reasonable time frame and budget
- Grade 12 (Essential)
- Relevant tertiary qualification
- FAIS Regulatory Examination (RE1) or FAIS Regulatory Examination (RE5)
- Minimum of 5-10 years’ managerial experience within the Insurance industry
- Computer literacy: Advanced MS Word, Excel and Outlook
- Facilitating executive and senior level executive engagements
- Knowledge of business policies, processes and procedures, compliance and regulatory environment for Long Term Insurance and Funeral Business Claims
- Knowledge of Claims processing, approval, and payment processes k31.5b

**Job Types**: Full-time, Permanent


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