PURPOSE OF THE ROLE

The Claims Team Leader is responsible for the overall management of the claims team. The duties include, managing, planning, monitoring and reporting. The Claims Team Leader reports to the Manager: PSSPF Claims.

AREAS OF RESPONSIBILITIES/ KEY ACTIVITIES

• Coordinate and monitor all claim related activities, which include the complete claim processing cycle of all claims, all claim related enquiries or complaints.
• Ensure all claims are quality assured and processed according to the rules, policies, legislation, administration procedures / processes and the service level agreements applicable to the Fund.
• Identify, develop, enhance, document and make proposals to implement policies, procedures and processes that are relevant to the claims team.
• Investigate, analyze and monitor escalations and complaints. Report trends and obtain approval from reporting manager for solutions to implement preventative measures.
• Support a positive and responsive climate for client enquiry resolution, respond to all complaints and enquiries, and submit response to the complainant / Compliance Team within the service level agreement. Follow through and ensure feedback is provided until resolved.
• Ensure communication, whether internal or external is dealt with professionally and within the service level agreement.
• Implement audit findings and recommendations.
• Assist in selecting, appointing and assigning team members.
• Provide input to job descriptions for team members within the claims team.
• Train, mentor and coach team members.
• Set and agree performance areas with staff and manage employee performance to ensure production standards are met in terms of quantity and quality.
• Delegate work to team members.
• Co-ordinate team’s leave.
• Report any irregularities to the reporting manager.
• Responsible for quality assessing (checking and releasing / audit confirm) of claims.
• Authorise payment of claims.
• Accept accountability and take responsibility for tasks done by reporting staff.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
• Any other duties as determined by the business needs and to participate in all organizational events as required.

RELATIONSHIP MANAGEMENT

• Build and maintain relationships at all levels with reporting staff, all stakeholders and internal departments to enhance organizational effectiveness and efficiency.
• Use your best endeavors to properly conduct, improve, extend, develop, promote, protect and preserve the business interests, reputation and goodwill of the company.

REPORTING

• Compile and provide accurate reports to the reporting manager, in the required format by the agreed deadlines, to keep management abreast of progress, delays and or backlogs

QUALIFICATIONS

• Matric with math’s.
• FICA awareness, POPI & TCF training.
• Good command of English both verbal and written.

ESSENTIAL KNOWLEDGE, SKILLS AND EXPERIENCE

• 5 – 6 years experience in the employee benefits / retirement fund industry of which at least 2 years practical experience in a leadership role (if external).
• Good interpersonal skills.
• Planning/Organizing: prioritize, work efficiently and productively and manage your time well.
• Problem Solving: ability to take a logical and analytical approach to solving problems and resolving issues.
• Adaptability/Flexibility: ability to manage reporting staff and multiple assignments and tasks, set priorities, and adapt to changing conditions and work assignments.
• Good verbal and written communication skills.
• Reliability.
• Responsibility.
• Ability to work under pressure.
• Good knowledge of Microsoft Outlook, Word, Excel and Power point.

ADDITIONAL

• Self-starter
• Innovative thinking
• High ethics
• Needs to appreciate the importance of filing and reports
• Detailed orientated

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