Team Lead: Life Claims-1life

**JOB PURPOSE**

To manage the life claims process ensuring the efficient and effective processing

of funeral claims. Mitigating risk and ensuring that only valid claims are paid.

Supervision of the life claims assessors. Assisting the claims manager in dealing

with escalated complaints. Testing of new systems and system enhancements.

To ensure that the life claims department complies with all relevant regulation

and legislation.

**RESPONSIBILITIES**

**Operations Management**

Supervise others working within established operational systems.

**Customer Management**

Manage relationships with clients and act as first point of contact for customer

queries and complaints and resolve these, referring complex issues to others

and ensuring that the customer receives an appropriate response.

**Stakeholder Management**

Deliver stakeholder engagement activities to support development of effective

project working relationships and to identify and respond to stakeholder needs

and concerns.

**Claims Management**

Review and analyse assigned claims in line with the organisation's standard

claims procedures and customer service standards. Overseeing 1Life life claim

assessors and performing internal audits. Assisting life assessors with claim

queries to ensure service levels are met. Constant reviewing of claim forms and

claim processes. Approving and paying of all life claims. Ensuring that claim

systems are functional and logging exceptions and enhancements when

required.

**Operational Compliance**

Maintain and renew a deep knowledge and understanding of the organisation's

policies and procedures and of relevant regulatory codes and codes of conduct,

and ensure own work adheres to required standards. Identify, within the team,

patterns of non-compliance with the organisation's policies and procedures, and

with relevant regulatory codes and codes of conduct, taking appropriate action to

report and resolve these and escalating issues as appropriate.

**Performance Management**

Respond to personal objectives and use performance management systems to

improve personal performance. Monitor the performance of the team; allocate

work and review completion, take appropriate corrective action to ensure

timeliness and quality; contribute to formal individual performance management

and appraisal.

**Work Scheduling and Allocation**

Assign short-term work schedules to a team of subordinates in order to achieve

expectations while following established timelines.

**Leadership and Direction**

Explain the local action plan and targets to support team members in their

understanding of what needs to be done and how this relates to the broader

business plan; motivate people to achieve local business goals and targets.

**Organisational Capability Building**

Use the organisation's formal development framework to identify the team's

individual development needs. Plan and implement actions to build their

capabilities. Provide training or coaching to others in own area of expertise to

enable others to improve performance and fulfil personal potential. Providing on

the job and formal training to the life assessors.

**Insights and Reporting**

Prepare and coordinate the completion of various data and analytics reports.

**Budgeting and Costing**

Requesting NHLS reports and reconciling the billing monthly.

**Personal Capability Building**

Keep abreast with current changes in internal policies and procedures, external

regulations which are facilitated by the online training system and tracked by a

formal assessment.

Keep up to date with business products and keep abreast of changes in the

insurance industry, including competitor products.

**BEHAVIORAL COMPETENCIES**

**Being Resilient**

Rebounds from setbacks and adversity when facing difficult situations. For

example, deals effectively with crises and volatile situations. Puts people's

failures in perspective and helps them move forward. Maintains calm in

adversity; stays objective. Uses hardships and difficult experiences as an

opportunity for personal and team growth.

**Directs Work**

Provides direction, delegating, and removing obstacles to get work done. For

example, delegates tasks, providing generally clear expectations to staff.

Coordinates and integrates the team's work, reducing duplication. Measures

team progress using the right indicators; recognizes when problems or shortfalls

occur.

**Ensures Accountability**

Holds self and others accountable to meet commitments. For example, helps

team hold each other accountable for goals, adherence to policies and

procedures. Tracks team metrics and milestones, redirecting effort, as

necessary, for continued progress.

**Drives Results**

Consistently achieves results, even under tough circumstances. For example,

creates a feeling of energy and an emphasis on excellence in the team, using

productive behaviours. Builds a strong sense of urgency to exceed goals and beat

deadline