Claims Manager

Prime Meridian Direct; Johannesburg; On-site; ZAR 300 000 - 400 000; Full time

Job summary

A leading insurance company in Johannesburg is looking for a dedicated individual to drive initiatives that ensure timely, cost-effective, and high-quality outcomes while enhancing customer satisfaction. The candidate will engage with team members, manage claims processes, and ensure compliance with internal procedures. Strong analytical, communication, and motivational skills are essential. If you are results-driven and thrive in a dynamic environment, we encourage you to apply now.

Qualifications

• Proven history of consistently meeting targets.
• Ability to manage a high volume of claim reviews in a fast-paced environment.
• Strong negotiation and decision-making skills.

Responsibilities

• Drive initiatives for timely and cost-effective outcomes.
• Regularly review claims to ensure accuracy.
• Monitor progress and adjust strategies as needed.
• Inspire and motivate team members to achieve objectives.
• Authorize changes to Estimated Completion Dates beyond 5 days.

Skills

Analytical skills

Effective communication

Team player

Technical proficiency in Microsoft Excel

Ability to work under pressure

Teaching and coaching

Process improvement

Job description

Overview

In this pivotal role, you’ll drive initiatives that ensure timely, cost-effective, and high-quality outcomes, all while enhancing customer satisfaction.

Responsibilities Perform Sample Checks : Regularly review claims to ensure accuracy and compliance.

Daily Clearance of Exceptions : Maintain operational efficiency by clearing exceptions daily.

Intra-Day Stats and Check-Ins : Monitor progress and adjust strategies as needed.

Authorise Expert Appointments : Review and approve requests for expert consultations.

Queue Management

Ensure all necessary queues are cleared daily.

Market Conduct Meetings : Actively participate to stay updated and compliant.

Claims Approval

Review claims over R75, and authorize approvals up to R,.

Team Objectives

Ensure your team meets set objectives and delivers required results.

Plan of Action (POA) : Review and test projected POAs for the upcoming days and weeks.

ECD Management

Authorize changes to Estimated Completion Dates beyond 5 days.

Greenline Process Adherence : Ensure compliance with internal processes.

Capacity Planning

Oversee resource allocation and workload distribution.

Technical Resource

Provide guidance and support on claims processes.

Continuous Training

Offer ongoing training and upskilling opportunities.

Auto Approval Process : Review and adjust to ensure maximum accuracy.

Exception Statistics : Monitor and manage exception statistics proactively.

Team Motivation

Inspire and motivate team members to foster a culture of high performance.

Process Improvement

Provide insights and recommendations for enhancing the claims process.

Performance Management : Offer ongoing feedback to support professional development.

High Volume Management : Ability to manage a high volume of claim reviews in a fast-paced environment.

Teaching and Coaching : Strong ability to teach and coach team members.

Results-Driven

Proven history of consistently meeting targets.

Work Under Pressure

Ability to perform well under pressure.

Analytical Skills

Strong analytical, negotiation, decision-making, and problem-solving skills.

Effective Communication : Excellent oral and written communication skills.

Team Player

Ability to work independently and as part of a team.

Technical Proficiency : Strong proficiency in Microsoft Excel and Internet navigation.

Process Improvement

Strong skills in process improvement and data analytics.

Team Environment

Enjoy working within a team environment.

Ready to embark on an exciting career journey with us?

Apply now!