Minimum requirements:

Completed Matric.
RE5 regulatory examination completed.
5 years experience with end-to-end claims processing.
At least 2 years experience in a supervisory role.
Works with urgency and manages the team and claims with a no-nonsense attitude.

Duties and Responsibilities:

Supervise and lead the team of claims analysts.
Assist the claims analysts with technical queries relating to claims.
Provide guidance, training and performance feedback to your team members.
Auditing and authorising of daily claims from the daily claims list to ensure accuracy.
Auditing of daily claims payments before payments are uploaded and finalized.
Develop and implement effective and efficient claims processing procedures.
Monitor the performance of the claims team, track key performance indicators (KPIs) and implement improvements as needed.
Ensure timely and accurate claims assessment, investigation and resolution.
Regularly analyse recovery possibilities, identify trends and implement strategies to improve recovery efforts. This may involve refining legal processes, analysing data for identification of recovery opportunities and collaborating with legal or investigative teams to strengthen recovery outcomes.
Work closely with brokers to address client inquiries, complaints and concerns.
Liaison with the risk carriers including scheduled and ad-hoc reporting on various claims reports as required.
Strive to enhance broker/client satisfaction through efficient claim processing.
Analyse claims data to identify patterns, trends and areas for improvement.
Generate reports on claims performance and present findings to management.
Collaborate with underwriting teams to assess risk factors and improve risk management strategies.
Develop and implement strategies to prevent fraudulent claims.
Communicate effectively with internal stakeholders, external partners, clients and brokers.
Provide regular updates to senior management on claims status, performance metrics and challenges.
Stay current on industry regulations and compliance requirements.
Implement and enforce compliance with company policies and procedures (claims check lists).
Collaborate with legal and compliance teams to address regulatory issues.
Handle and oversee claim complaints.