Claims Team Leader - ADA - JHB at Bryte Insurance Company Limited

Requirements

Key Tasks & Accountabilities

Effective control and monitoring of leakage

• Ensure business standards and agreed SLAs of all claim’s related matters are adhered to.
• Review open and closed files and establish procedures and controls to minimize leakage.
• Assess audit report of leakage and attend to identified leakage.
• Complete fraud list and Identify claims that requires further fraud verification.
• Review re-open claims and ensure recovery, journals and notes are made on internal systems.
• Locate leakage and follow up progress monthly to Claims Manager and QA
• Review company leakage reports to identify variances and recommended actions.

Effective quality control

• Conduct audits per technician per month using leakage form/checklist.
• Ensure all information and standards are adhered to with regards to financial transactions
• Authorize and sign payments together with checklists.
• Clear allocation queues on Workflow as per roster to manage work distribution.
• Complete claims rejections within two days of receiving the repudiation task and within SLA and forward to Broker Managers.
• Review pending payments and ensure none outstanding over 1 day.
• Ensure Technicians are appointing the correct assessors and on a rotation basis; report irregularities to Claims Manager timeously. 
• Ensure timeous changing of file owners.

Effective reporting and analysis

• Review all QA and Operational reports as and when required and provide feedback and/or action plan to address issues.

Effective customer focus and service

• Provide exceptional customer in line with TCF.
• Liaise with internal stakeholders to facilitate problem resolution and efficiency of work activities.
• Communicate with stakeholders on a daily basis to inform of progress of claims and claim policy and procedure.
• Deal with and resolve any queries relevant to area; if unable to resolve, escalate to manager for resolution
• Represent the organization through maintaining high levels of professionalism, service excellence and customer excellence.
• Adhere to internal policies, processes, and procedures.

Effective people management and team leadership

• Lead by example in living the values of Bryte.
• Monitor staff workload on a daily basis.
• Explain and train new claim instructions, bulletins and training materials.
• Be an active part of corrective action to ensure those correcting fully understand errors and consequences.
• Ensure registers are completed daily.
• Monitor staff with regards to time keeping, dress code, behaviours and absenteeism and take corrective action when required.
• Identify and address variances/breaches of polices, standards, performance, etc.
• Create an environment that fosters teamwork and co-operation amongst team members.
• Communicate effectively, building and maintaining relationships.
• Ensure consistent compliance to company policies and procedures, corporate governance, and relevant legislation.

Performance Management

• Conduct monthly review meetings for all technicians in order to assess performance and provide constructive feedback and establish action plans as applicable to feed to the claims manager.
• Identify poor performance and put correctional measure in line with performance management policy.

Claims Cost Management

• Continuously monitor and manage the quality of the claims handled and completed through conducting sample auditing on an on-going basis.
• Recommend improvements to reduce average cost per claim.
• Review the service of different vendors repairers in conjunction with agreed vendor contracts with specific regard to cost containment.
• Ensure that claims handlers are compliant and adhering to business requirements and standards, check guidelines as stipulated by service level contracts and agreements with relevant stakeholders, internally and externally.
• Ensure compliance with company policies, and ensure appropriate action taken where necessary and required.
• Ensure that all claims’ handlers provide relevant and correct information to clients/repairers to ensure that work is completed according to set standards and agreements, that ensures best interest of the client and the company in relation to claims management.
• To direct and control spend

People Management Accountabilities

• Claims Team leader will be responsible for the operational management for the technicians reporting to the Claims Manager.

Qualification & Experience

• Matric (Preferable with Degree)
• 5 years claims handling/ adjustment experience.
• 1-2 years people management experience

Relationship

Internal Relationship

• All Claims Departments
• Sales
• Underwriting

External Relationship

• Brokers
• Clients
• Claims
• Suppliers
• Service Providers

Closing date: 29 March 2024