Senior Manager: IL Claims Administration (Long Term Insurance)

AtripleA recruitment & temps; Pretoria; On-site; ZAR 810,000 - 990,000; Full time

Job summary

A leading insurance hiring firm is seeking a Senior Manager: IL Claims Administration in Pretoria. This role involves monitoring claims management, designing procedures, and overseeing audits. Candidates must have a relevant degree, RE1 & RE5, and at least 5 years of experience in long-term insurance claims along with 5-8 years in a management position. A strong understanding of claims processes and fraud detection is essential. Attractive salary package negotiable.

Qualifications

• At least 5 years of experience in long-term insurance claims.
• 5-8 years of experience in Management.

Responsibilities

• Monitor management of claims administration on individual life policies.
• Design and develop standard operating procedures.
• Oversee the management of efficient and effective administration of claims.

Skills

Risk Management

Business Management

Claims Management

Fraud Detection

Process Design

Education

Degree in Risk Management or Business Management

RE1 & RE 5

Registration as a Key Individual

60 or 120 credits on NQF level 5

Job description

Senior Manager: IL Claims Administration_Long Term Insurance

Sector: Insurance

Location: Pretoria

Salary: R900 000 (negotiable)

Our client in the insurance sector is looking for a Claims Administrator to monitor the management of individual life claims administration.

Responsibilities

• Monitor management of claims administration on individual life policies
• Design and develop standard operating procedures
• Oversee the management of efficient and effective administration of claims
• Align Branch Office procedures with Head Office procedures
• Monitor processes and procedures for the detection of fraud activities on claims
• Provide inputs to forensics, IT department and external fraud forum
• Decide and discuss dispute claims
• Decide on ex-gratia payments in agreement with Senior Executive Manager
• Monitor payment turn-around time of finalized
• Sign-off finalized approved claims payments
• Co-ordinate complaints resolution and compliance
• Provide inputs into strategy
• Management of implementation of claims workflow and audits
• Conduct claims audits at branches to comply with claims rules and procedures
• Manage implementation of processes that are followed and completed for audits
• Monitor completion and updates of loss/near loss register
• Provide feedback on processes to auditors
• Provide feedback to auditors on steps taken to ensure claims are paid correctly
• Provide feedback to Risk Manager
• Design and develop processes for unclaimed assets
• Align unclaimed assets with claims rules and process
• Obtain an external service provider to trace the policy holders
• Attend the unclaimed asset committee meetings
• Chair unclaimed assets committee and align with requirements
• Report on IL Claims Administration

Requirements

• Degree: Risk Management/Business Management/relevant
• RE1 & RE 5
• Registration as a Key Individual
• 60 or 120 credits on NQF level 5 (Depending on the date of appointment in the industry)
• 5 Years' Experience in long term insurance claims
• At least 5-8 years in Management

Send your CV and latest pay slip to [e-mail]

AtripleA Recruitment and Temps

www.aaaa.co.za