Claims Manager

Green Marble Recruitment Consultants; Gauteng; On-site; ZAR 300,000 - 400,000; Full time

Job summary

A leading recruitment firm is seeking a dynamic Claims Manager to oversee a team dedicated to end-to-end claims processing. This pivotal role requires strong leadership skills, the ability to identify trends and fraud, and a proactive approach to strategy implementation. The position, based in Randpark Ridge, offers a competitive monthly salary.

Qualifications

• Minimum 5 years' experience in end-to-end claims processing.
• At least 2 years' experience in a supervisory role.
• Ability to work with urgency and handle claims effectively.

Responsibilities

• Supervise and lead the team of claims analysts.
• Audit and authorize daily claims to ensure accuracy.
• Develop and implement strategies to prevent fraudulent claims.

Skills

Collaboration mindset

Fraud detection

Team management

Education

Completed Matric

RE5 regulatory examination

Job description

Reference : JHB-DDT -1

Are you an experienced leader with a passion for driving efficiency and excellence in claims resolution and management?

We're seeking a dynamic Claims Manager to oversee our clients' end-to-end claims process and lead a dedicated team of claims analysts.

We are looking for an individual with a strong personality, a collaboration mindset, and the capability to identify trends, detect fraud, and implement strategies for claims prevention.

Position is based in Randpark Ridge.

Duties & Responsibilities

1. Supervise and lead the team of claims analysts.
2. Assist claims analysts with technical queries related to claims.
3. Provide guidance, training, and performance feedback to team members.
4. Audit and authorize daily claims to ensure accuracy.
5. Audit daily claims payments before finalization.
6. Develop and implement effective claims processing procedures.
7. Monitor team performance, track KPIs, and implement improvements.
8. Ensure timely and accurate claims assessment, investigation, and resolution.
9. Analyze recovery opportunities, identify trends, and implement strategies to enhance recovery efforts, including refining legal processes and collaborating with legal or investigative teams.
10. Work closely with brokers to address client inquiries, complaints, and concerns.
11. Coordinate with risk carriers and provide scheduled and ad-hoc claims reports.
12. Enhance broker and client satisfaction through efficient claims processing.
13. Analyze claims data to identify patterns and areas for improvement.
14. Generate and present claims performance reports to management.
15. Collaborate with underwriting teams to assess risk factors and improve risk management strategies.
16. Develop and implement strategies to prevent fraudulent claims.
17. Communicate effectively with internal and external stakeholders.
18. Provide regular updates to senior management on claims status and challenges.
19. Stay current on industry regulations and compliance requirements.
20. Ensure compliance with company policies and procedures, including claims checklists.
21. Collaborate with legal and compliance teams on regulatory issues.
22. Handle and oversee claim complaints.

Minimum Requirements

• Completed Matric.
• RE5 regulatory examination completed.
• Minimum 5 years' experience in end-to-end claims processing.
• At least 2 years' experience in a supervisory role.
• Ability to work with urgency, manage the team, and handle claims with a no-nonsense attitude.

Package & Remuneration: R 60,000 - R 70,000 Monthly