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Job Description

Job Description
This role is a Team Leader in the Corporate Administration Services environment.  The individual will manage a Claims team, pertaining to all functions of non-risk claims.  The individual needs to have an extraordinary passion for positive customer outcomes while driving and achieving daily and monthly operational targets.  The incumbent is individually accountable for achieving results through others, over periods of 1 day to 3 months.

Duties and Responsibilities

•    Manages daily operational (client service and or administrative) delivery within specific functional area.
•    Delivers, maintains and enhances service / work standards and work quality via a team , within a given processes.
•    Drives operational excellence through area of supervision.
•    Owns operational efficiency, quality, operations scorecard targets, including people
•    Accountable for technical decision making of a function as well as management of work volumes / flow.
•    Implements effective and appropriate operational processes
•    Establishes and maintains client / customer relationships.
•    Builds relationships with peers, colleagues and multiple stakeholders across business areas and value chain.
•    Could take accountability for the implementation of a strand of an operational project.
•    Extensive experience in day to day management.
•    Manages between 15 and 25 staff (could include some specialist staff).
•    Responsible for the implementation and monitoring of productivity
•    Review and maintaining skill competencies of the team

Role Qualifications and requirements
•    Matric (essential) 
•    Undergraduate degree (preferable)
•    Experience with process improvement methodologies
•    Experience with Leading people
•    Strong analytical and problem-solving skills
•    Strong interpersonal and client relationship skills
•    Strong communication skills (both verbal and written)
•    Proven ability to work independently and proactively
•    Claims, Compass and Chorus knowledge is advantageous

Ensures that general insurance claims are handled expeditiously and in a professional manner thereby meeting the customer expectations. Manages the claims function with a team of claims assessors and negotiators. Develops the claims policy, procedures, and practices. Evaluates risks with claims, coverage complexity, and those in excess of field approval limits. Provides counsel regarding claims evaluation and coverage.

ResponsibilitiesFraud/Financial Crime Investigation

Contribute to the investigation of cases of suspected fraud or financial crime by gathering, analyzing, and retaining information and physical evidence to support criminal investigation and/or legal action. Recommend further actions to the lead investigator.

Fraud/Financial Crime Management

Deliver fraud prevention reporting and analysis for a designated area of operations, using financial crime/fraud prevention systems to identify instances, patterns, and trends of suspicious activity, to enable the prevention of fraud and enable the initiation of loss mitigations and fraud investigations.

Fraud/Financial Crime-Management Systems Development

Review external research and analysis, and analyze customer or client transactions to identify fraud trends and emerging risks, and to support the development of fraud/financial crime prevention strategies, policies, procedures, and monitoring systems.

Insurance Claims Administration

Review and analyze complex insurance claims in line with the organization's standard claims procedures and customer service standards. Initiate investigations and engage independent loss adjusters and/or subject-matter experts where appropriate. Authorize claims within delegated authority and refer unresolved issues or disputes to line manager.

Insurance Claims Evaluation

Investigate the circumstances of claims and the nature and extent of clients' losses. Review and evaluate information gathered using own subject-matter expertise, and examine additional evidence provided by specialist investigators or subject-matter experts to determine the extent of liability. Negotiate settlement of insured losses in line with delegated authority.

Leadership and Direction

Explain the local action plan, to support team members in their understanding of what needs to be done, and how this relates to the broader business plan and the organization's strategy, mission, and vision; motivate people to achieve local business goals.

Work Scheduling and Allocation

Assign short-term work schedules to a team of subordinates in order to achieve expectations while following established timelines.

Financial Policies, Guidelines, and Protocols

Contribute to the development and delivery of financial policies, guidelines, and protocols to ensure the company complies with regulations and good financial practice.

Organizational Capability Building

Provide coaching to team members to develop their skills.

Performance Management

Respond to personal objectives and use performance management systems to improve personal performance; or monitor the performance of the team, allocate work and review completion, take appropriate corrective action to ensure timeliness and quality, and contribute to formal individual performance management and appraisal.

Regulatory and Compliance Management

Investigate standard incidents using current regulatory and compliance processes, systems, and procedures, and take action to solve immediate compliance issues. Advise more senior colleagues on more complex problems.

Solutions Analysis

Interpret data and identify possible answers. Involves navigating a wide variety of processes, procedures, and precedents.

Skills

Action Planning, Claims Management, Client Management, Current State Assessment, Data Compilation, Data Controls, Executing Plans, Financial Auditing, Insurance Claims Investigations, Leadership, Management of Employees, Oral Communications, Policies & Procedures, Problem Solving, Sharp Analytical Mind, Typology

Competencies

Business InsightCommunicates EffectivelyDecision QualityDirects WorkEnsures AccountabilityFinancial AcumenInstills TrustManages Complexity

Education

Matriculation Certificate (Matric) (Required)

Closing Date

17 March 2025 , 23:59

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

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