Team Manager: Claims

PPS Recruitment; Johannesburg; On-site; ZAR 900,000 - 1,200,000; Full time

Job summary

PPS Recruitment in Johannesburg is seeking an experienced Claims Team Leader to manage a Personal Lines and Commercial Lines claims team, ensuring effective settlements and timely finalisations.

You will lead performance, maintain compliance, and drive customer satisfaction while coaching staff and aligning processes with TCF and risk controls. The role requires 10+ years in short-term claims, with 3+ years in leadership and relevant insurance qualifications.

Qualifications

• 10+ years in a Short-Term Insurance claims environment (Commercial and Personal Lines).
• 3+ years in team leading/management or acting in such role.
• COP/ Intermediate or Higher certificates in Insurance Studies or Diploma in Short Term insurance.
• Insurance Management qualification would be advantageous.

Responsibilities

• Lead a team responsible for Personal Lines and Commercial Line claims.
• Authorize claims within the approved Delegation of Authority.
• Respond promptly to queries/escalations from members, Advisors/Brokers and stakeholders.
• Align and maintain processes to ensure effective claims assessment and decisions.
• Explain targets to staff and monitor performance against objectives (satisfaction, experience, cost, governance).
• Drive risk awareness and controls within the claims team and report losses.
• Ensure TCF principles are embedded in the claims process.

Skills

Customer service

Claims process knowledge

Communication skills

Negotiation skills

Leadership and motivation

Team collaboration

Pressure handling

Prioritisation and multitasking

Education

Grade 12 (NQF level 4)

COP/ Intermediate or Higher certs in Insurance

Diploma in Short-Term Insurance

Tools

Codeplex

Job description

To effectively control, guide and manage a claims team responsible for the PPS Short Term Insurance claims and to drive and deliver exceptional performance through maximum effectiveness in claims process (settlement and or finalisation) to our PPS members.

Ensure best practice and supporting the company in meeting its objectives.

Education:

• NQF level 4: Grade 12
• COP/ Intermediate and Higher certificates in Insurance Studies or Diploma in Short term insurance
• Insurance Management qualification would be advantageous.

Experience:

• 10+ years’ experience within a Short-Term Insurance claims environment (both for Commercial and Personal Lines), of which 3 years spend as a team leader, team manager and or acting in such role.
• Codeplex experience would be an advantage.

Knowledge and Skills:

• Customer Service Skills
• Thorough understanding of claims handling process
• Knowledge of Commercial and Personal Lines claims processes and the validation thereof
• Negotiation Skills
• Knowledge of the Auto Body repair industry
• Problem solving
• Business Acumen
• Writing and communication skills – including the ability to communicate technical information
• The ability to prioritize and multi-task
• Teamwork, leadership and motivational skills
• Persuading and influencing
• Proactive thinking
• People skills and able to communicate at all levels
• Able to handle pressure situations

Duties and Responsibilities

Role and Responsibilities

• Lead a team responsible for Personal Lines and Commercial Line claims
• Authorise claims within the approved Delegation of Authority
• Respond promptly to all queries/escalations raised by members, Internal Advisors/Brokers and other stakeholders
• Align and maintain processes to ensure effective claims assessment and decisions are taken
• Explain targets to all claims staff and take accountability for the monitoring and achievement of performance objectives in the department in terms of employee satisfaction, customer experience, cost performance, compliance and governance requirements
• Drive risk awareness and controls within the claims team and report any operational loses
• Ensure that TCF (Treating Customers Fairly) principles are embedded in the claims assessment process

People Leadership and Culture

• Provide team leadership ensuring the effective implementation of strategy through leadership of the team members (setting individual objectives, managing performance developing and motivating staff, provision of formal and informal feedback and appraisal) in order to ensure that the highest level of performance is achieved.
• Mentor team members as needed or required; conducts peer review of key deliverables
• Creates an environment where people are encouraged to take ownership and use their initiative to find the best way of implementing plans
• Build and maintain relationships with PPS service providers and work closely with the PPS Technical Operations Manager to stay abreast of claims investigations.
• Build and maintain relationship with PPS Technical Operations Manager to support claims assessors/investigators to ensuring clear, concise and transparent communication.

Risk and Compliance

• Adhere to internal SLA's to ensure operational efficiency and achievement of agreed customer service standards
• Identify trends in claims and train consequences thereof into the claims team
• Ensure adherence to audit requirements
• Ensure adherence to regulatory and compliance requirements.

People and Culture

• Create a motivated work environment where employees want to work hard to achieve service excellence by providing regular feedback on their performance and by making sure that the employees' efforts are recognized
• Determine and analyse training needs for the claims team and ensure that all agreed development/training interventions are scheduled, approved and executed
• Ensure continuous improvement and updating of work instructions and process documents
• Provide input in development and updating guidelines to support the assessment/investigation of claims.