Claims Operations Manager

Placements24; South Africa; On-site; ZAR 900,000 - 1,200,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Paid time off

Professional development

Job summary

Placements24 in Pretoria, Gauteng, seeks a seasoned Claims Operations Manager to lead the claims department and optimize processing. You will guide a team of claims adjusters and support staff to ensure efficient, accurate, and customer-centric settlements.

The role requires 6+ years in claims management with leadership, strong knowledge of SA regulations, and the ability to drive cost controls and service improvements. A competitive package awaits in a stable insurer setting.

Qualifications

• Bachelor's degree in Business Administration or Management.
• 6+ years in insurance claims management, including 3+ years in leadership.
• Proven track record with high-volume claims operations.
• Knowledge of Property, Casualty, and Motor lines.
• Understanding SA insurance regulations.

Responsibilities

• Oversee and motivate the claims handling team to operational excellence.
• Develop and implement efficient claims workflows.
• Monitor performance metrics and identify improvement areas.
• Ensure accurate and timely settlement in line with policy terms.
• Manage budgets and control costs.
• Foster relationships with internal units, service providers, and policyholders.
• Ensure compliance with regulatory requirements.
• Implement quality assurance programs for adjudication.
• Drive initiatives to enhance customer experience throughout the claims journey.

Skills

Leadership

Operational management

Process improvement

Customer-centric service

Analytical skills

Communication

Interpersonal skills

Education

Bachelor's degree

Tools

Claims management software

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.