Claims Team Leader

3 weeks ago

Johannesburg, South Africa Bryte Insurance Full time

**Who we are.**

To direct, control, and monitor the relevant claims team and operations therein and review and authorise claim settlement payments in line with internal policy and process.

Key Tasks & Accountabilities

Effective control and monitoring of leakage
- Ensure business standards and agreed SLAs of all claim’s related matters are adhered to.
- Review open and closed files and establish procedures and controls to minimize leakage.
- Assess audit report of leakage and attend to identified leakage.
- Complete fraud list and Identify claims that requires further fraud verification.
- Review re-open claims and ensure recovery, journals and notes are made on internal systems.
- Locate leakage and follow up progress monthly to Claims Manager and QA
- Review company leakage reports to identify variances and recommended actions.

Effective quality control
- Conduct audits per technician per month using leakage form/checklist.
- Ensure all information and standards are adhered to with regards to financial transactions
- Authorize and sign payments together with checklists.
- Clear allocation queues on Workflow as per roster to manage work distribution.
- Complete claims rejections within two days of receiving the repudiation task and within SLA and forward to Broker Managers.
- Review pending payments and ensure none outstanding over 1 day.
- Ensure Technicians are appointing the correct assessors and on a rotation basis; report irregularities to Claims Manager timeously.
- Ensure timeous changing of file owners.

Effective reporting and analysis
- Review all QA and Operational reports as and when required and provide feedback and/or action plan to address issues.

Effective customer focus and service
- Provide exceptional customer in line with TCF.
- Liaise with internal stakeholders to facilitate problem resolution and efficiency of work activities.
- Communicate with stakeholders on a daily basis to inform of progress of claims and claim policy and procedure.
- Deal with and resolve any queries relevant to area; if unable to resolve, escalate to manager for resolution
- Represent the organization through maintaining high levels of professionalism, service excellence and customer excellence.
- Adhere to internal policies, processes, and procedures.

Effective people management and team leadership
- Lead by example in living the values of Bryte.
- Monitor staff workload on a daily basis.
- Explain and train new claim instructions, bulletins and training materials.
- Be an active part of corrective action to ensure those correcting fully understand errors and consequences.
- Ensure registers are completed daily.
- Monitor staff with regards to time keeping, dress code, behaviours and absenteeism and take corrective action when required.
- Identify and address variances/breaches of polices, standards, performance, etc.
- Create an environment that fosters teamwork and co-operation amongst team members.
- Communicate effectively, building and maintaining relationships.
- Ensure consistent compliance to company policies and procedures, corporate governance, and relevant legislation.

Performance Management
- Conduct monthly review meetings for all technicians in order to assess performance and provide constructive feedback and establish action plans as applicable to feed to the claims manager.
- Identify poor performance and put correctional measure in line with performance management policy.

Claims Cost Management
- Continuously monitor and manage the quality of the claims handled and completed through conducting sample auditing on an on-going basis.
- Recommend improvements to reduce average cost per claim.
- Review the service of different vendors repairers in conjunction with agreed vendor contracts with specific regard to cost containment.
- Ensure that claims handlers are compliant and adhering to business requirements and standards, check guidelines as stipulated by service level contracts and agreements with relevant stakeholders, internally and externally.
- Ensure compliance with company policies, and ensure appropriate action taken where necessary and required.
- Ensure that all claims’ handlers provide relevant and correct information to clients/repairers to ensure that work is completed according to set standards and agreements, that ensures best interest of the client and the company in relation to claims management.
- To direct and control spend

People Management Accountabilities
- Claims Team leader will be responsible for the operational management for the technicians reporting to the Claims Manager.

Qualification & Experience
- Matric (Preferable with Degree)
- 5 years claims handling/ adjustment experience.
- 1-2 years people management experience

Relationship

Internal Relationship
- All Claims Departments
- Sales
- Underwriting

External Relationship
- Brokers
- Clients
- Claims
- Suppliers
- Service Providers

Closing date: 29 March 2024

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