Team Lead: Life Claims-1Life at 1 Life Insurance

RESPONSIBILITIES

Operations Management

• Supervise others working within established operational systems.

Customer Management

• Manage relationships with clients and act as first point of contact for customer queries and complaints and resolve these, referring complex issues to others and ensuring that the customer receives an appropriate response.

Stakeholder Management

• Deliver stakeholder engagement activities to support development of effective project working relationships and to identify and respond to stakeholder needs and concerns.

Claims Management

• Review and analyse assigned claims in line with the organisation's standard claims procedures and customer service standards. Overseeing 1Life life claim assessors and performing internal audits. Assisting life assessors with claim queries to ensure service levels are met. Constant reviewing of claim forms and claim processes. Approving and paying of all life claims. Ensuring that claim systems are functional and logging exceptions and enhancements when required.

Operational Compliance

• Maintain and renew a deep knowledge and understanding of the organisation's policies and procedures and of relevant regulatory codes and codes of conduct, and ensure own work adheres to required standards. Identify, within the team, patterns of non-compliance with the organisation's policies and procedures, and with relevant regulatory codes and codes of conduct, taking appropriate action to report and resolve these and escalating issues as appropriate.

Performance Management

• Respond to personal objectives and use performance management systems to improve personal performance. Monitor the performance of the team; allocate work and review completion, take appropriate corrective action to ensure timeliness and quality; contribute to formal individual performance management and appraisal.

Work Scheduling and Allocation

• Assign short-term work schedules to a team of subordinates in order to achieve expectations while following established timelines.

Leadership and Direction

• Explain the local action plan and targets to support team members in their understanding of what needs to be done and how this relates to the broader business plan; motivate people to achieve local business goals and targets.

Organisational Capability Building

• Use the organisation's formal development framework to identify the team's individual development needs. Plan and implement actions to build their capabilities. Provide training or coaching to others in own area of expertise to enable others to improve performance and fulfil personal potential. Providing on the job and formal training to the life assessors.

Insights and Reporting

• Prepare and coordinate the completion of various data and analytics reports.

Budgeting and Costing

• Requesting NHLS reports and reconciling the billing monthly.

Personal Capability Building

• Keep abreast with current changes in internal policies and procedures, external regulations which are facilitated by the online training system and tracked by a formal assessment.
• Keep up to date with business products and keep abreast of changes in the insurance industry, including competitor products.

EDUCATION General Education

• Matric / Grade 12 or SAQA Accredited Equivalent (Essential)
• Regulatory Exam
• 5 (Advantageous); NQF5 Wealth Management qualification (Advantageous)
• Class of Business (Advantageous)
• RE1 and ASISA Claims Assessor Course (Advantageous)

EXPERIENCE General Experience

• 5 or more years funeral supervision experience within the long-term insurance industry (Essential)
• 3-5 years junior claims management experience in the life underwriting environment (Advantageous) relevant medical insurance knowledge (Essential)

Managerial Experience

• 1 or more years' experience of supervising and directing people and other resources to achieve specific end results within limited timeframes (advantageous)