Merit Investigations Team Manager

6 days ago

Midrand, South Africa Sanlam Full time

**Who are we?**
- Job Description- The purpose of the role will be to manage the team of Merit Claims Investigators responsible for investigation component of suspicious and potential fraudulent claims. Ensuring that all flagged and segmented Claims are comprehensively investigated to achieve conclusive results and coordinating all claims investigation efforts and all other relevant stakeholders e.g. Forensic Services, Insurance Crime Bureau (SAICB)
- Key Responsibilities- Manages and leads a team of Merit Claims Assessors
- Ensure on-going development of resource by mentoring, guidance and both formal and informal training.
- Ensuring effective management of high-quality standards.
- Reporting on effective management of claims.
- Drive customer centricity in line with MiWay core values.
- Prioritise, allocate, manage and monitor investigation of high merit risk claims.
- Effective merit claims investigation of appropriate quality.
- Consultation with clients, Third parties, Business and Business Partners on a continuous basis
- Qualifications and Experience- Matric/Grade 12
- Degree in Legal or Forensic Qualification will be advantageous.
- Advanced knowledge of short-term insurance industry
- Relevant experience in the investigation of fraudulent claims
- Minimum 4 years short-term insurance experience
- Minimum 3 years Claims investigations experience
- Supervisory/Management experience
- Solid understanding of TIA and MIA claims system and claims procedures: inclusive of claims, investigations and legal department processes
- Skills- Computer Literate (MS Office Package)
- Strong interviewing skills, capacity to influence and win confidence.
- Interpersonal skills (work in a team or independently)
- Problem solving abilities & abilities to make decisions.
- Strong analytical abilities and evaluate trends objectively.
- Desired Skills- Investigation of fraudulent claims
- Investigations
- Short term insurance industry
- Project Management
- Forensic Qualification
- Interviewing skills
- Conflict Management
- Analytical
- Competencies Required- Must be highly proficient in dealing with clients at all levels.
- Comprehensive knowledge of legal liability and state regulations
- Thorough knowledge of claims investigation techniques
- Excellent written and verbal communication skills
- Attention to detail.
- Supervisory skills
- Self-motivated, inspire others.
- Motivation and desire to excel.
- Problem solving skills and solution oriented.
- Flexibility
- Ability to multi-task and cope with pressure
- Performance management experience
- Commitment to personal and team goals
- Professionalism
- Good interviewing skills
- Provide technical guidance to team members.

**Knowledge and Skills**
- Drive leads and service targets- Coaching, quality and compliance- Reporting and communication- Management of employees**Personal Attributes**
- Decision quality - Contributing independently- Interpersonal savvy - Contributing independently- Plans and aligns - Contributing independently- Directs work - Contributing independently**Build a successful career with us**
- We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future - your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realise their worth. Through its five business clusters - Sanlam Fintech, Sanlam Life and Savings, Sanlam Investment Group, Sanlam Allianz, Santam, as well as MiWay and the Group Office - the group provides many opportunities for growth and development.**Core Competencies**
- Cultivates innovation - Contributing independently- Customer focus - Contributing independently- Drives results - Contributing independently- Collaborates - Contributing independently- Being resilient - Contributing independently**Turnaround time**Our commitment to transformation**

At MiWay we believe in cultivating a positive and dynamic working environment that gives you freedom and opportunity to succeed. MiWay is committed to transformation and embracing diversity. This is what drives us to achieve a multicultural workplace with employment equity as a key goal to create an inclusive workforce, reflective of the demographics of our society.

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