Claims Operations Manager

Placements24; Pretoria; Hybrid; ZAR 900,000 - 1,500,000; Full time

Benefits offered by this job

Competitive salary

Health insurance

Retirement plan

Paid time off

Training programs

Career development

Job summary

Placements24 in Pretoria is seeking an experienced Claims Operations Manager to oversee a high-volume claims team. You will optimize workflows, ensure timely settlements, and manage budgets while upholding regulatory standards.

The role requires 6+ years in claims management with 3+ years in leadership, strong leadership and communication skills, and proficiency with claims software. A key focus is improving customer experience and controlling costs.

Qualifications

• Bachelor's degree in Business Administration, Management, or a related field.
• Minimum of 6 years in insurance claims management, with at least 3 years in a leadership or supervisory role.
• Proven track record in managing high-volume claims operations.
• In-depth knowledge of Property, Casualty, Motor and other lines and claims best practices.
• Strong operational management and process improvement skills.
• Excellent leadership, communication, and interpersonal abilities.
• Proficiency in claims management software and systems.
• Strong analytical and problem-solving skills.
• Understanding of South African insurance regulations.

Responsibilities

• Lead the claims handling team to achieve operational excellence.
• Develop and implement efficient claims processing workflows and procedures.
• Monitor claims performance metrics and identify areas for improvement.
• Ensure accurate and timely settlement of claims in line with policy terms.
• Manage claims budgets and control operational costs.
• Build strong relationships with internal teams, service providers, and policyholders.
• Ensure compliance with regulatory requirements and company policies in Pretoria.
• Implement quality assurance programs to maintain high adjudication standards.
• Drive initiatives to enhance customer experience throughout the claims journey.

Skills

Leadership

Claims management

Process improvement

Budgeting

Communication

Regulatory compliance

Stakeholder management

Education

Bachelor's degree in Business Administration/Management

Job description

About the Role

Our client is looking for a motivated and experienced Claims Operations Manager to oversee their claims department in Pretoria, Gauteng . This leadership role is vital for ensuring efficient, accurate, and customer-centric claims processing. The ideal candidate will have a strong background in claims management, a deep understanding of insurance policies, and exceptional operational and people management skills. You will be responsible for optimizing claims workflows, managing a team of claims adjusters and support staff, and implementing best practices to enhance customer satisfaction and control costs. This is a significant opportunity to make a tangible impact within a reputable insurance company operating from Pretoria , driving improvements in a critical business function.

Key Responsibilities

• Lead, manage, and motivate the claims handling team to achieve operational excellence.
• Develop and implement efficient claims processing workflows and procedures.
• Monitor claims performance metrics and identify areas for improvement.
• Ensure accurate and timely settlement of claims in accordance with policy terms and conditions.
• Manage claims budgets and control operational costs effectively.
• Develop and maintain strong relationships with internal departments, external service providers, and policyholders.
• Ensure compliance with all regulatory requirements and company policies related to claims handling in Pretoria, Gauteng .
• Implement quality assurance programs to maintain high standards of claims adjudication.
• Drive initiatives to enhance customer experience throughout the claims journey.

Requirements

• Bachelor's degree in Business Administration, Management, or a related field.
• Minimum of 6 years of experience in insurance claims management, with at least 3 years in a leadership or supervisory role.
• Proven track record in managing high-volume claims operations.
• In-depth knowledge of various insurance lines (e.g., Property, Casualty, Motor) and claims best practices.
• Strong operational management and process improvement skills.
• Excellent leadership, communication, and interpersonal abilities.
• Proficiency in claims management software and systems.
• Strong analytical and problem-solving skills.
• Understanding of South African insurance regulations.

Benefits

Our client offers a competitive salary, performance-based incentives, comprehensive health insurance, retirement savings plan, and generous paid time off. There are ample opportunities for professional development, training programs, and career advancement. This role in Pretoria offers a challenging yet rewarding environment with a focus on work-life balance and employee well-being.