Life Claims Manager

1 week ago

Johannesburg Metropolitan Area, South Africa Clientele Limited Full time R250 000 - R350 000 per year

Purpose:

To help Clientele achieve its vision of being South Africa's most reliable and valued financial services partner. This should be done through:

  • the proactive management of claims and the claims department,
  • ensuring that controls and procedures are in place to deliver on our service levels at all times,
  • adhering to legislative requirements,
  • optimising of spend, and
  • ensuring a high quality service is rendered whilst always upholding Clientele's values and Treating Clients Well, by paying all valid claims.

Key Areas of Responsibility:

1. Management of Claims Life Cycle: Applying industry acceptable standards whilst adhering to all regulations, codes, standards and legislation. All assessments, pending, repudiated claims and payments are conducted in accordance with the applicable terms and conditions for the specific policy taking into account all treaty agreements with reinsurers. 

2. Staffing: Establish and measure team activities against pre-set targets, standards and SLA's.

Responsible to ensure that all Assessors are current and up to date with product knowledge, systems use, and related legislation application. This should be driven through a formalised learning and development programme, within prescribed time lines and standards. 

3. Reinsurance: Understanding the balance between claims payments and reinsurance rates and profitability of a product.

4. Forensics: Keeping abreast of fraud within the industry and constantly revising assessment methods applying the latest information to protect the Company against fraudulent activities.

  1. Reporting: Monthly reporting and monitoring of all activities within the Claims area. Statistical analysis and forecasting of potential effects that any changes could have on future activities is beneficial in the effective management of this portfolio. 

6. Relationship Management: Investing effort in identifying and building internal and external stakeholder relationships. 

  1. Projects: Management of and participation in strategic or operational claims or business projects that is delivered within the required time frame.

  2. Affiliates Oversight: Providing oversight on the end to end claims process for the Strategic Affiliates business

Qualification and Skill Requirements:

  • Extensive knowledge and experience in the long-term insurance / financial services administration industry
  • 5 – 10 years' experience as a Manager in the long-term insurance claims environment
  • Matric, Tertiary qualification advantageous
  • Reinsurance and Product knowledge is a great advantage.

Behavioural Competencies:

  • Strong Administrative and Organizational experience
  • Dynamic self –starter
  • Maintaining good customer service

Functional Competencies (Skills)

  • Extensive knowledge of the day-to-day management of a claims division as well as the application of all relevant legislation, codes of conduct, standards and procedures is required as the basis of a Claims Management Position.
  • These include internal Company requirements as well as Industry requirements as set out by ASISA and other regulatory bodies.
  • Computer Literacy (Efficient in Microsoft Office)
  • Proven people management experience.

Personal Characteristics

  • Time management
  • Ability to delegate
  • Ability to work under pressure
  • Attention to detail
  • Interpersonal skills
  • Good communication skills (oral and written)
  • Knowledge of the company disciplinary code
  • Strong organisational ability and skills
  • Decision making ability
  • Leadership ability
  • Customer focus
  • Planning and organising

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