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Claims Operations Manager
2 weeks ago
Matric Certificate with Mathematics
Regulatory Exam and Higher Certificate in Short term Insurance - NQF 5
Degree in Law or Risk Management or similar is preferred
Leadership / Management Development Certification is preferred
Class of Business certification (Personal Lines & Commercial Lines)
Must be compliant with FAIS Fit and Proper requirements with track-record of supervising Reps
Experience in niche products such as Marine and Engineering highly beneficial
Computer literate Microsoft Word, Excel, and Outlook
The Claims Manager will be responsible for providing strategic direction and overall leadership in the total, large, and complex Short-Term Insurance Motor and Non Motor Claims process. This role operates in a deadline-driven environment, ensuring that all claims received are flawlessly assessed, evaluated, and investigated, within reasonably agreed turn-around times. The Manager ensures that claims are paid in accordance with policy cover and identifies and reports bad risks.
At least 12-15 years relevant work experience in Short-Term Insurance Claims validations and settlement for both Personal Lines and Commercial Lines Motor and Non-Motor claims
At least 8 years experience working for an Insurer/ Risk carrier in a managerial capacity essential
Experience required in process engineering strategy development and implementation, budget management, policy wording, claims guidelines and risk acceptance
The Claims Manager will be responsible for providing strategic direction and overall leadership in the total, large, and complex Short-Term Insurance Motor and Non Motor Claims process
This role operates in a deadline-driven environment, ensuring that all claims received are flawlessly assessed, evaluated, and investigated, within reasonably agreed turn-around times
The Manager ensures that claims are paid in accordance with policy cover and identifies and reports bad risks
The Claims Manager works closely with Senior Claims Management, and other operational business leaders to ensure that; estimates reserved are correct and reviewed quarterly, large movements are reported, and that files are complete at settlement
The Claims Manager is responsible for achieving optimal levels of efficiency of claims operating procedures so that highest standard of quality and customer service is maintained
The Manager ensures that ad hoc quality audits are performed on finalised claims files and implements corrective measures where unwanted findings occur.
Specialist level technical knowledge and understanding of relevant short term insurance policy wording required
Takes appropriate and calculated risks displaying high levels of integrity and transparency in decision making
**Key clients**
Brokers, internal staff and managers, service providers & policy holders
