Claims Manager

Vacancy

Two Mountains is look for a Claims Manager for their Midrand office on a permanent basis.

Purpose of the Job

Lead, organize, and oversee the operations of the claims team to continually improve customer experience. Uphold the utmost standards of customer service, adhering to all company policies, including regulatory TCF (Treat Customer Fairly) principles, to achieve organizational goals effectively.

Key Outputs

  • Claims Assessment
    • Oversee the entire claims process from initial notification to settlement or resolution. This involves assessing the validity of claims, investigating them thoroughly, and making decisions on their outcome.
    • Lead and supervise a team of claims assessors. Provide guidance, support, and training to ensure effective handling of claims and adherence to company policies and procedures.
    • Ensure that all claims are processed in compliance with relevant laws, regulations, and company policies. Stay updated on changes in regulations and make necessary adjustments to claim procedures.
    • Maintain a high level of customer satisfaction by providing clear communication and timely updates on claim status.
    • Analyse claim data and trends to identify potential risks and areas for improvement in claims handling processes. Develop strategies to mitigate risks and reduce claim costs.
    • Ensure accurate and thorough documentation of all claim-related activities, including investigations, communications, and settlement agreements. Generate reports on claim metrics, trends, and performance indicators for management review.
    • Identify and investigate suspicious claims for possible fraud or misrepresentation. Work closely with fraud detection units and legal teams to prevent fraudulent activities and minimize financial losses.
    • Continuously review and refine claim management processes to enhance efficiency, accuracy, and customer satisfaction. Implement best practices and innovative solutions to optimize claim handling operations.

Administration / Office Support:

  • Compile and report the reviews to key internal stakeholders.
  • Provide support, guidance, leadership, and motivation to promote maximum performance to the team

Minimum Qualifications:

  • Related qualification and/or Certificates in Insurance.
  • Proven experience in risk and claims assessment.
  • RE1 & RE5 qualifications

Experience Required:

  • A minimum of 8 years in the Life Insurance Industry.
  • 5 years’ experience in life insurance claims assessor role.
  • FAIS – Long Term.
  • Project and budget planning an advantage.
  • Business report writing skills.
  • Computer proficiency to work effectively with certain assessment tools or software.
  • PowerPoint preparation and presentations skills.

Technical Competencies:

  • Analytical Skills
  • Well-developed listening, written and oral communication skills
  • High analytical mind
  • Ethical, focused on treating customers fairly
  • Respect for customer and business confidentiality.

Behavioral Competencies /Performance Drivers

  • Strong personality, with the confidence to take the initiative
  • Detail- and deadline-oriented multitasker
  • Attention to detail
  • Ability to work on tight deadlines.
  • Excellent verbal and written communication skills
  • Problem Solving
  • Teamwork
  • Work Ethics and Values.

Closing Date: 15 March 2024

Suitable candidates should forward their applications to: hr@twomountains.co.za 

Two Mountains is an equal opportunity employer subscribing to the Employment Equity Act and hereby invites applications from suitably qualified people to fill the mentioned vacancy.

  • If you do not hear from us within a month of the closing date, please regard your application as unsuccessful.
  • Applications received after the closing date will not be considered.
  • It is the applicant`s responsibility to have foreign qualifications evaluated by the South African Qualifications Authority (SAQA).
  • Only candidates who meet the requirements should apply.
  • Two Mountains reserves the right not to make an appointment.
  • Correspondence will be entered into with shortlisted candidates only.
  • CVs from Recruitment Agencies will not be accepted.