Manager: Claims Administration at Assupol

Duties & Responsibilities:

Manage claims administration: individual life and group scheme policies

• Implement standard operating procedures for all claims received within the claims department.
• Management of efficient and effective administration of all claims at Head Office and branch level according to best practice
• Ensure quality claims assessment is rendered to all clients of Assupol
• Ensure written communication is done professionally and validate the correctness thereof
• Monitor and control claims processes and procedures
• Identify possible gaps in processes and procedures and provide solutions to management
• Oversee branch Office procedures are in line with Head Office procedures
• Implement processes and procedures for the detection of fraud activities on claims
• Provide inputs on dispute claims with Assupol Risk Committee
• Provide inputs on ex-gratia payments in agreement with Senior Manager: Claims
• Keep abreast with changes and updates of the industry
• Manage payment turn-around time of finalized claims (TCF)
• Sign-off and approve claims payments (TCF)
• Ensure clients are treated fairly the claims journey

Manage performance and development of staff

• Identify development areas for all staff in the department and provide guidance thereof
• Evaluation on performance of staff
• Ensure all new employees are inducted into the department

Provide Reports to Senior Manager: IL Claims Administration

• Oversee the maintaining of allocated registers within the department
• Compile reports for manager on claims activities
• Compile internal audit findings report with feedback and planning to Snr Manager on monthly basis
• Compile analysis report on claims scenarios to Snr manager on monthly basis

Implementation of claims workflow and audits

• Implement processes are followed and completed for audits taking place from Re Insurers as well as internal and external auditors
• Provide feedback on audit findings to Snr Manager
• Provide feedback to Snr Manager on steps taken to ensure claims processes are followed in claims administration
   

Requirements
Formal Education:

• Degree: B: Business Management/relevant
• RE1 & RE 5
• Registration as a Key Individual
• 60 or 120 credits on NQF level 5 (Depending on the date of appointment in the industry)

Experience:

• 5 Years’ Experience in long term insurance claims; At least  2 years in Management