Team Lead - Menlo Park at Road Accident Fund

Key Performance Areas

Merits Management

• Scrutinise claim documentation (e.g. payslips, medico legal reports, hospital records etc.).
• Ensure that appropriate offers are made to deserving claimants.
• Supervise assessors in respect of work to be done and work done.
• Generate and compare different calculation results by interpreting and utilizing the information in reports.
• Handle all the escalated matters and ensure resolution thereof.
• Supervise the determination of liability processes.
• Quality assure merits outcomes and generate the offer in line with the DOA.
• Ensure that offers made are submitted the offer management for further communication to the claimant.
• Approve the appointment of the relevant experts to approve liability of the RAF.
• Provide guidance on the merits process to subordinates.
• Confirm a need and reasons to submit claims for further investigation

Quality assurance

• Quality assure the information applicable to merits on the accident information Centre.
• Participate in the consultations process on the implementation of programs and services.
• Ensure that programs and services are implemented and maintained at the highest standards.
• Implement the development and implementation an unusual occurrence procedure.

Exception handling

• Implement the development of additional tracking methods to report analysis results in business case scenarios.
• Implement the development and maintenance a formal exception handling process within the claims process.
• Maintain the documentation and regular updating of the exception handling process.  
• Implement supporting policies and procedures in line with managing exception handling with the division.

Stakeholder management

• Aid in proactive and progressive relationships with key stakeholders.
• Deal with inquiries and requests for information from both internal and external stakeholders.
• Aid in the maintenance of relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.

Reporting

• Ensure preparation and submission of Regulation reports.
• Report quarterly on progress with implementation of operational plans.
• Ensure development of functional reporting systems, project or performance reporting for management.
• Ensure the development of reports/ policies/ procedures and guide the process through the alignment of these documents to the overall RAF’s Strategy.
• Ensure regular and periodic reports are prepared and submitted as and when required to provide progress updates and/or inform management decisions.

People management

• Ensure the motivation, cohesiveness, and alignment of the organization’s team members.
• Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.

Qualifications and Experience

• Bachelor’s Degree/ Advanced Diploma in a Health Sciences or Law related qualification.
• Relevant 5 years’ experience in an Insurance or Investigations related environment of which 2 years must be in the operations management function.