The Claims Manager is responsible for the overall management of the claims department. The duties include, managing, planning, monitoring and reporting. Providing assistance to Client Services, the Call Centre, Claims team, employers and external service providers. The Claims Manager reports to the Snr Manager PSSPF.

Areas of Responsibilities

• Meet production standards in terms of quantity and quality.
• Liaise with employers and service providers both written and verbal.
• Devote the whole of your time, attention and abilities during working hours to the discharge of your duties with strict accuracy.
• Ensure email communication, whether internal or external is dealt with professionally and within the service level agreement.
• Coordinate and monitor all claims related activities which includes payment of claims, reporting, data maintenance and client enquiries.
• Ensure all funds comply and is administered according to the rules, policies, legislation, administration procedures and the service level agreements applicable to each fund.
• Identify, develop, enhance and implement policies and procedures that are relevant to the claims department.
• Follow up on audit findings and recommendations.
• Compile job descriptions for all levels within the claims department.
• Set and agree performance areas with staff and manage employee performance.
• Delegate work to staff.
• Coordinate departmental leave.
• Compile accurate reports required by management in the required format.
• Any other duties as determined by the Senior Manager: PSSPF Claims.

Record Keeping and Filing

• Keep all email correspondence for future reference

Query resolution

• Attend to all email and telephonic enquiries both internal and external.
• Assist Client Services, the Call Centre, Claims team, employers and external service providers to resolve queries.
• Follow through and provide client with on-going feedback until enquiry is resolved.
• Support a positive and responsive climate for client enquiry resolution.
• Action all escalated enquiries within 24 – 72 hours.
• Report any irregularities to the Senior Manager: PSSPF Claims.
• Monitor escalations and complaints and recommend preventative measures.

Team Support

• Accept accountability and take responsibility for any work done or allocated.
• Display a willing and helpful attitude.
• Select, assign, lead and manage people
• Train, mentor and coach staff.
• Maintain staff relations.

Relationship Management

• Build and maintain relationships at all levels with service providers 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

Time Management

• Excellent time management.
• Must be available to work overtime when the need arises.
• Flexible and ability to work under pressure and multitask.

Education, Language & Qualifications

• Matric certificate with maths.
• Good command of English.
• FICA awareness training.

Essential Knowledge, skills and Experience

• At least 6 years employee benefits / retirement fund administration experience specifically in a similar role processing retirement fund claims and dealing with employers and external providers.
• A solid knowledge of pension fund legislation, regulations and guidelines.
• Everest experience will be advantageous.
• Knowledge and understanding of unitization.
• Good knowledge of Microsoft Outlook, Word and Excel.
• Excellent numerical skills with attention to detail and accuracy.
• Methodical and meticulous.
• Good verbal and written communication skills.
• A self-starter who can work independently with minimal support but who can also work in a team environment.

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