Death Claims QA, Complaints and Training Specialist

Jobtailor; Cape Town; On-site; ZAR 420,000 - 520,000; Full time

Job summary

Jobtailor in Cape Town seeks an experienced Quality Assurance and Training Specialist to support end-to-end GAP QA, complaints handling, and training initiatives within retirement fund operations. The role involves reviewing outputs, investigating complaints, and coordinating remediation with cross-functional teams to ensure regulatory compliance and high-quality service.

Applicants should possess strong QA, data analysis, and root cause analysis skills, with at least 5 years in retirement fund

Qualifications

• Computer literacy at intermediate level (Word, Excel, Outlook, PowerPoint).
• Knowledge of GAP products, group risk benefits, claims administration or related retirement fund processes is advantageous.
• Experience in quality assurance, training, coaching, complaints resolution, root cause analysis or operational governance is strongly advantageous.
• Excellent written and verbal communication skills.
• Strong interpersonal, facilitation, negotiation and stakeholder management skills.
• Ability to work under pressure, manage sensitive matters and apply sound judgement in high-risk or high-impact situations.
• Planning, organising, reporting and follow-through skills.
• Tact, diplomacy and empathy when dealing with complaints and sensitive customer matters.
• Sound problem-solving skills.
• Matric or relevant tertiary qualification.
• Strong analytical and logical reasoning skills.
• Self-motivated and action-oriented.
• Knowledge of retirement fund administration, Section 37C, group life assurance, claims processes, audit requirements or financial services legislation is advantageous.
• At least 5 years’ retirement fund, group risk, claims, client service, quality assurance, complaints or training experience.
• System knowledge such as Compass, Chorus, EMS or other relevant claims, workflow and reporting tools is advantageous.
• Third-party administration, insurance, claims or group risk experience is advantageous.
• Proven ability to work independently and proactively while maintaining accurate records and evidence.

Responsibilities

• Support end-to-end GAP quality assurance, complaints and training functions.
• Review work outputs and perform quality assurance reviews across customer communication, complaint handling, calculations, workflow actions, system updates and supporting evidence.
• Provide complaint responses to stakeholders, including regulators and internal stakeholders.
• Acknowledge and respond to complaints within SLA.
• Investigate complaints using case history, evidence, system notes, communications and process requirements.
• Identify complaint themes, repeat failures, service breakdowns and conduct risks.
• Draft evidence-based, empathetic and professional complaint responses.
• Coordinate remediation actions with operations, quality assurance, training, legal, compliance and management stakeholders.
• Maintain complaints registers and produce complaints MI, trend analysis and insight reports.
• Handle escalated GAP client queries, complex complaints, high-risk quality failures and urgent stakeholder escalations.
• Apply QA methodologies, sampling principles, check sheets and error classifications.
• Record errors, complaint themes, process deviations and training gaps for trend analysis.
• Provide feedback, coaching input and escalation support.
• Maintain QA registers, dashboards, MI packs and audit evidence files.
• Design, coordinate and deliver GAP training, refresher sessions and coaching interventions.
• Develop learner guides, assessments, attendance records and training evidence.
• Monitor training effectiveness and translate findings into learning topics and remedial action plans.
• Perform root cause analysis and support continuous improvement of GAP processes, controls, SOPs, templates, checklists and knowledge material.
• Produce ad hoc, weekly, monthly and quarterly reports.
• Work with support areas and stakeholders to achieve service standards, quality targets and complaint resolution outcomes.

Skills

Quality Assurance

Root Cause Analysis

GAP Training

Data Analysis

Complaint Handling

Reporting

Process Improvement

Error Classification

Workflow Management

Claims Administration

Education

NQF Level 4

Grade 12 Certificate

Tools

Word

Excel

Outlook

PowerPoint

Compass

Chorus

EMS

Job description

• Support end-to-end GAP quality assurance, complaints and training functions
• Review work outputs and perform quality assurance reviews across customer communication, complaint handling, calculations, workflow actions, system updates and supporting evidence
• Provide complaint responses to stakeholders, including regulators and internal stakeholders
• Acknowledge and respond to complaints within SLA
• Investigate complaints using case history, evidence, system notes, communications and process requirements
• Identify complaint themes, repeat failures, service breakdowns and conduct risks
• Draft evidence-based, empathetic and professional complaint responses
• Coordinate remediation actions with operations, quality assurance, training, legal, compliance and management stakeholders
• Maintain complaints registers and produce complaints MI, trend analysis and insight reports
• Handle escalated GAP client queries, complex complaints, high-risk quality failures and urgent stakeholder escalations
• Apply QA methodologies, sampling principles, check sheets and error classifications
• Record errors, complaint themes, process deviations and training gaps for trend analysis
• Provide feedback, coaching input and escalation support
• Maintain QA registers, dashboards, MI packs and audit evidence files
• Design, coordinate and deliver GAP training, refresher sessions and coaching interventions
• Develop learner guides, assessments, attendance records and training evidence
• Monitor training effectiveness and translate findings into learning topics and remedial action plans
• Perform root cause analysis and support continuous improvement of GAP processes, controls, SOPs, templates, checklists and knowledge material
• Produce ad hoc, weekly, monthly and quarterly reports
• Work with support areas and stakeholders to achieve service standards, quality targets and complaint resolution outcomes

Requirements

• Computer literacy essential (Word, Excel, Outlook, PowerPoint) at intermediate level
• Knowledge of GAP products, group risk benefits, claims administration, complaints handling or related retirement fund processes is advantageous
• Experience in quality assurance, training, coaching, complaints resolution, root cause analysis or operational governance is strongly advantageous
• Excellent written and verbal communication skills
• Strong interpersonal, facilitation, negotiation and stakeholder management skills
• Ability to work under pressure, manage sensitive matters and apply sound judgement in high-risk or high-impact situations
• Planning, organising, reporting and follow-through skills
• Tact, diplomacy and empathy when dealing with complaints and sensitive customer matters
• Sound problem-solving skills
• Matric or relevant tertiary qualification
• Strong analytical and logical reasoning skills
• Self-motivated and action-orientated
• Knowledge of retirement fund administration, Section 37C, group life assurance, claims processes, audit requirements or financial services legislation is advantageous
• At least 5 years’ retirement fund, group risk, claims, client service, quality assurance, complaints or training experience
• System knowledge such as Compass, Chorus, EMS or other relevant claims, workflow and reporting tools is advantageous
• Third-party administration, insurance, claims or group risk experience is advantageous
• Proven ability to work independently and proactively while maintaining accurate records and evidence
• NQF Level 4 / Grade 12, school leaving certificate, national or occupational certificate or equivalent

Core Competencies

Demonstrates expertise in quality assurance, complaints resolution, and training within the retirement fund sector, with a strong focus on stakeholder communication and root cause analysis. Proficient in utilizing various tools and methodologies to enhance service standards and operational governance.

Highest-signal resume keywords

• Quality Assurance
• Complaints Resolution
• Root Cause Analysis
• Training Development
• Stakeholder Management

Hard Skills

• Quality Assurance Methodologies
• Root Cause Analysis
• GAP Training
• Data Analysis
• Complaint Handling
• Reporting
• Process Improvement
• Error Classification
• Workflow Management
• Claims Administration

Soft Skills

• Excellent Communication Skills
• Interpersonal Skills
• Problem-Solving Skills
• Empathy
• Negotiation Skills

Certifications & Qualifications

• NQF Level 4
• Grade 12 Certificate

Industry Keywords

• Retirement Fund Administration
• Group Risk
• Claims Processes
• Financial Services Legislation
• Operational Governance

Tools & Technologies

• Word
• Excel
• Outlook
• PowerPoint
• Compass
• Chorus
• EMS