Manager Claims

Risk Benefit Solutions (Pty) Ltd

Western Cape, South Africa


May 3

This job is no longer accepting applications.

Role Purpose
To effectively and efficiently manage the claims department to provide superior claims service and build excellent relationships with service providers, thereby ensuring the retention and support the business strategy. Outputs
• Take appropriate action to minimise cancellations
• Ensure retention targets are met
• Ensure appropriate minimisation of claims and claims expenses
• Ensure and contribute to minimisation of general expenses
• Ensure that all stakeholder (e.g. insurer, account executive, client) communication is accurate, timeous, professional and relevant
• Build and maintain mutually beneficial relationships with internal and external stakeholders
• Ensure and contribute to achieving own and company required client satisfaction targets
• Manage claim process end to end
• Process and ensure all claims and recoveries are processed within the required parameters
• Ensure effective complaint resolution within the required time lines
• Ensure service level agreements are met
• Follow and ensure adherence to claims settlement processes
• Follow and ensure adherence to underwriting processes for cancellations
• Ensure adherence to company mandates
• Manage the compilation and distribution of reports as required
• Utilise reports to action interventions and improvements
• Take responsibility to ensure payments by from insurer to broker and broker to client are timely and complete
• Inform and advise underwriters regarding underwriting risks posed to claims
• Approve valid and complete mandated claims for payment
• Execute regular quality assurance reviews to ensure compliancy as per the claims methodology
• Participate and contribute in ad hoc projects
• Report any suspected fraud, misrepresentation and/or dishonesty
• Live the RBS values
• Ensure continuous self-development
• Share information and knowledge with the team
• Ongoing training, coaching and mentoring of direct reports
• Performance management of direct reports

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