Gap Claims Operations Team Leader

Kaelo; KwaZulu-Natal; On-site; ZAR 300,000 - 400,000; Full time

Job summary

A leading insurance company in KwaZulu-Natal is looking for a Gap Claims Team Leader to manage claims approval and enhance team efficiency. The role involves ensuring exceptional customer service, coaching team members, and monitoring daily performance metrics. Candidates should have experience in the insurance sector and strong leadership skills. Various analytical, communicative, and customer-focused attributes are crucial for this position.

Qualifications

• Experience in the insurance industry is required.
• Claims handling experience is necessary.
• Previous team management and leadership experience is required.

Responsibilities

• Manage the authorization of claims ensuring efficiency.
• Coaching and peer-to-peer learning within the team.
• Monitor team performance and compliance with SLAs.

Skills

Communication skills

Analytical ability

Time management

Customer focus

Ability to adapt to an ever changing environment

Coping well under pressure

Education

Grade 12 – Matric

RE 5

Accreditation with professional body (minimum of 120 credits)

Tools

Microsoft Access

Job description

Overview

The Gap Claims Team Leader manages both the authorisation of claims and has specialised knowledge of the claims environment. There is a strong focus on accurately and efficiently resolving the claim received whilst ensuring exceptional customer service and satisfaction. The claims team leader has the responsibility of ensuring that the claims team carry out their responsibility while keeping the team motivated and efficient. The claims team leader works closely with the Claims Manager and Claims Operations Executive.

Key outcomes

• Reporting and Managing Key Team Deliverables
• Monitoring of the daily dashboard to ensure adherence to SLA
• Monitoring the teams accurate and efficient processing of claims
• Contribute towards continuous improvement and innovation at process and procedure level
• To ensure that all claims processing and queries are attended to accurately and within the agreed turnaround time
• Monitoring of daily performance statistics and workforce management
• Daily claims focus and work allocation
• Assist clients with escalated queries and provide suitable query resolution
• Accurate completion of people management tasks on a daily basis
• Ongoing feedback to clients
• People and Team Management
• People and team management
• Ensuring participative leadership and strong communication within the team
• Collaboration with all business areas
• Coaching and peer to peer learning
• Knowledge and Quality Management
• Developing of all employees and ensuring smooth onboarding for new employees.
• Review, maintenance and improvement of all processes and document management
• Quality assurance and trending
• Contribute toward risk management

Qualifications

SPECIAL REQUIREMENTS

• Communication skills
• Analytical ability
• Time management
• Customer focus
• Ability to adapt to an ever changing environment
• Cope well under pressure

Work Experience

PERSON DETAILS :

REQUIRED

• Insurance industry experience
• Claims experience
• Team management and leadership experience

PREFERRED

• Health Insurance industry

Education and Qualifications

QUALIFICATIONS : ACCREDITATIONS WITH PROFESSIONAL BODY

• RE 5
• Grade 12 – Matric
• Accreditation would be advantageous (a minimum of 120 credits)

Technical Skills

TECHNICAL SKILLS OR KNOWLEDGE

• Computer literate, including Microsoft Access
• Gap Claims knowledge

Personal Attributes

• Accountability
• Action orientated
• Collaborative
• Communication
• Business writing skills
• Manages complexity
• Problem solving skills
• Decision
• Growth and development mind-set
• Financial acumen
• Planning and organisation
• Resilient and adaptive
• Self-development
• Purpose driven
• Significance and values orientate