Insurance Dispute Resolution Specialist

3 weeks ago


Johannesburg, Gauteng, South Africa The Recruitment Council Full time
Job Description:

The Recruitment Council is seeking a highly skilled Insurance Dispute Resolution Specialist to join our team. This role involves managing the dispute resolution process related to long-term insurance, ensuring compliance and effective handling of complaints.

Key Responsibilities:
  1. Complaint Management
  • Oversee the recording and tracking of all complaints in the Client Relationship Management (CRM) database, ensuring all details are accurately documented for reference.
Documentation Handling
  • Ensure that all relevant documents, including physical copies and supporting materials, are properly uploaded and maintained for each complaint.
Process Improvement
  • Identify opportunities for enhancing client service and operational processes by analyzing service gaps and compliance issues, and recommending actionable solutions.
Stakeholder Liaison
  • Maintain communication with relevant business units to ensure timely and satisfactory responses to complaints, while monitoring the progress of each case.
Risk Mitigation
  • Proactively highlight any reputational or financial risks associated with service gaps or non-compliance, and develop strategies to address these issues.
Regulatory Compliance
  • Stay informed about changes in insurance legislation and industry standards, participating in ongoing education and training to maintain expertise.
Knowledge Sharing
  • Foster a culture of knowledge sharing by keeping the team updated on regulatory changes and best practices within the industry.
Client Communication
  • Ensure that clients receive timely updates and responses regarding their complaints, and provide necessary documentation to support claims processing.
Relationship Building
  • Establish and maintain effective relationships with both internal teams and external stakeholders through workshops and discussion forums.
Reporting
  • Respond promptly to inquiries from the Ombudsman and regulatory bodies, ensuring that all resolutions are completed within stipulated deadlines.

We estimate the salary for this position to be around $120,000 per year, depending on experience and qualifications.



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