Claims Manager

Red Ember Recruitment (Pty) Ltd; Wes-Kaap; On-site; ZAR 800,000 - 1,200,000; Full time

Job summary

Red Ember Recruitment is currently seeking an experienced Claims Manager on behalf of our client, based in Tygervalley, Bellville. This is an excellent opportunity for an experienced short-term insurance professional with strong leadership capabilities to oversee the end-to-end claims function.

The successful candidate will manage claims operations, lead a claims team, ensure regulatory compliance and maintain high service delivery standards while managing financial risk.

Qualifications

• Matric certificate is required.
• NQF 4 or 5 in Short-Term Insurance.
• Minimum 8 years of claims handling experience in motor or non-motor claims.
• Strong technical understanding of policy interpretation and liability assessments.
• Proven leadership of teams, workloads and performance.
• Experience with SLAs, KPIs and turnaround times.
• Experience handling escalations, complaints and high-value claims.

Responsibilities

• Oversee the complete claims lifecycle from notification to final settlement.
• Lead and mentor the claims team and provide training on handling techniques and legislative requirements.
• Establish performance standards in line with regulatory requirements.
• Oversee investigations and validate coverage, liability and settlement decisions.
• Develop claims strategies and policies to control costs and ensure compliance.
• Analyse claims data, forecast volumes and identify risks.
• Build relationships with brokers, clients, loss adjusters and service providers.
• Handle escalated complaints and disputes with focus on client satisfaction.

Skills

Team leadership

Policy interpretation

Liability assessments

Claims settlements

SLA / KPI management

Escalation handling

Stakeholder management

Data analysis

Education

Matric certificate

NQF Level 4/5 in Short-Term Insurance

Job description

Red Ember Recruitment is currently seeking an experienced Claims Manager on behalf of our client, based in Tygervalley, Bellville.

This is an excellent opportunity for an experienced short-term insurance professional with strong leadership capabilities and technical claims expertise to oversee the end-to-end claims function. The successful candidate will be responsible for managing claims operations, leading a claims team, ensuring regulatory compliance and maintaining high service delivery standards while managing financial risk.

• Oversee the complete claims lifecycle, from initial notification through to final settlement.
  
• Manage complex and high-value claims, providing technical guidance and strategic direction.
  
• Establish, monitor and maintain claims performance standards in line with operational objectives and regulatory requirements.
  
• Oversee claims investigations and validate coverage, liability and settlement decisions.
  
• Lead, manage, mentor and develop the claims team.
  
• Provide ongoing training on claims handling techniques, procedures and legislative requirements.
  
• Conduct performance evaluations, set individual objectives and monitor team performance.
  
• Develop and implement claims strategies and policies aimed at controlling costs and ensuring compliance.
  
• Analyse claims data, prepare performance reports, forecast claims volumes and identify potential risks.
  
• Build and maintain effective relationships with internal and external stakeholders, including brokers, clients, loss adjusters and service providers.
  
• Handle escalated complaints and disputes while ensuring a high level of client satisfaction.
  

Requirements

• Matric certificate.
  
• NQF Level 4 or NQF Level 5 qualification in Short-Term Insurance.
  
• Minimum of 8 years' claims handling experience, within motor or non-motor claims.
  
• Strong technical understanding of policy interpretation, liability assessments and claims settlements.
  
• Proven experience managing teams, workloads and operational performance.
  
• Experience working with claims processes, Service Level Agreements (SLAs), Key Performance Indicators (KPIs) and turnaround times.
  
• Demonstrated experience handling escalations, complaints and complex or high-value claims.
  
• Experience engaging with brokers, clients, loss adjusters and external service providers.
  

Advantageous Qualifications

• Degree or Diploma in Insurance, Risk Management or Business Administration.
  
• Additional qualification in Management or Business Leadership.