Team Lead: Life Claims-1Life

1Life Insurance

  • Gauteng
  • Permanent
  • Full-time
  • 1 month ago
JOB PURPOSETo manage the life claims process ensuring the efficient and effective processingof funeral claims. Mitigating risk and ensuring that only valid claims are paid.Supervision of the life claims assessors. Assisting the claims manager in dealingwith escalated complaints. Testing of new systems and system enhancements.To ensure that the life claims department complies with all relevant regulationand legislation.RESPONSIBILITIESOperations ManagementSupervise others working within established operational systems.Customer ManagementManage relationships with clients and act as first point of contact for customerqueries and complaints and resolve these, referring complex issues to othersand ensuring that the customer receives an appropriate response.Stakeholder ManagementDeliver stakeholder engagement activities to support development of effectiveproject working relationships and to identify and respond to stakeholder needsand concerns.Claims ManagementReview and analyse assigned claims in line with the organisation's standardclaims procedures and customer service standards. Overseeing 1Life life claimassessors and performing internal audits. Assisting life assessors with claimqueries to ensure service levels are met. Constant reviewing of claim forms andclaim processes. Approving and paying of all life claims. Ensuring that claimsystems are functional and logging exceptions and enhancements whenrequired.Operational ComplianceMaintain and renew a deep knowledge and understanding of the organisation'spolicies and procedures and of relevant regulatory codes and codes of conduct,and ensure own work adheres to required standards. Identify, within the team,patterns of non-compliance with the organisation's policies and procedures, andwith relevant regulatory codes and codes of conduct, taking appropriate action toreport and resolve these and escalating issues as appropriate.Performance ManagementRespond to personal objectives and use performance management systems toimprove personal performance. Monitor the performance of the team; allocatework and review completion, take appropriate corrective action to ensuretimeliness and quality; contribute to formal individual performance managementand appraisal.Work Scheduling and AllocationAssign short-term work schedules to a team of subordinates in order to achieveexpectations while following established timelines.Leadership and DirectionExplain the local action plan and targets to support team members in theirunderstanding of what needs to be done and how this relates to the broaderbusiness plan; motivate people to achieve local business goals and targets.Organisational Capability BuildingUse the organisation's formal development framework to identify the team'sindividual development needs. Plan and implement actions to build theircapabilities. Provide training or coaching to others in own area of expertise toenable others to improve performance and fulfil personal potential. Providing onthe job and formal training to the life assessors.Insights and ReportingPrepare and coordinate the completion of various data and analytics reports.Budgeting and CostingRequesting NHLS reports and reconciling the billing monthly.Personal Capability BuildingKeep abreast with current changes in internal policies and procedures, externalregulations which are facilitated by the online training system and tracked by aformal assessment.Keep up to date with business products and keep abreast of changes in theinsurance industry, including competitor products.BEHAVIORAL COMPETENCIESBeing ResilientRebounds from setbacks and adversity when facing difficult situations. Forexample, deals effectively with crises and volatile situations. Puts people'sfailures in perspective and helps them move forward. Maintains calm inadversity; stays objective. Uses hardships and difficult experiences as anopportunity for personal and team growth.Directs WorkProvides direction, delegating, and removing obstacles to get work done. Forexample, delegates tasks, providing generally clear expectations to staff.Coordinates and integrates the team's work, reducing duplication. Measuresteam progress using the right indicators; recognizes when problems or shortfallsoccur.Ensures AccountabilityHolds self and others accountable to meet commitments. For example, helpsteam hold each other accountable for goals, adherence to policies andprocedures. Tracks team metrics and milestones, redirecting effort, asnecessary, for continued progress.Drives ResultsConsistently achieves results, even under tough circumstances. For example,creates a feeling of energy and an emphasis on excellence in the team, usingproductive behaviours. Builds a strong sense of urgency to exceed goals and beatdeadlines. Ensures that the team pushes through obstacles and establishes asuperior track record.Communicates EffectivelyDevelops and delivers multi-mode communications that convey a clearunderstanding of the unique needs of different audiences. For example, tailorscommunication content and style to the needs of others. Pays attention to others'input and perspectives, asks questions, and summarizes to confirmunderstanding.Customer FocusBuilds strong customer relationships and delivers customer-centric solutions. Forexample, solicits customer feedback and data; conveys a clear understanding ofthe level of service the team is providing; takes action when standards are notmet by team; aligns business process with customer needs.Manages ConflictHandles conflict situations effectively, with a minimum of noise. For example,responds quickly and constructively to emerging conflicts; redirects those whoengage destructively in conflicts; seeks mutually agreeable outcomes. Maintainspositive and constructive relationships, even under heated disagreements.CollaboratesBuilds partnerships and works collaboratively with others to meet sharedobjectives. For example, encourages coworkers and external partners to worktogether as a team and makes sure they get credit for doing so. Encouragespeople to share their honest views, responds in a non-defensive way when theydo.Develops TalentDevelops people to meet both their career goals and the organization's goals.For example, shares own experience and expertise with others if asked.Provides constructive feedback and other support for other people'sdevelopment.Manages ComplexityMakes sense of complex, high quantity, and sometimes contradictory informationto effectively solve problems. For example, looks at complex issues frommultiple angles; explores issues to uncover underlying issues and root causes.sees the main consequences and implications of different options.Manages AmbiguityOperates effectively, even when things are not certain or the way forward is notclear. For example, responds effectively to unclear situations, seeks to resolveambiguity and make progress. Seeks guidance on how to adapt to changes,responds with appropriate composure and effectiveness.SKILLSClaims ManagementWorks at an advanced level to handle individual and portfolios of claims costeffectively, minimising claims leakage, and meeting organisational and customerclaims service standards. Typically works independently and provides guidance.Customer Service DeliveryWorks independently using comprehensive knowledge and skills while guidingand training others on meeting high customer service standards.Verbal and written CommunicationApply comprehensive knowledge and guide and train others to use clear andeffective verbal and written communication skills to express ideas, requestactions and formulate plans or policies.Action Planning and Work SchedulingUses comprehensive knowledge and skills to work independently while providingguidance and training to others on developing appropriate plans or performingnecessary actions based on recommendations and requirements.Computer and System skillsSupport business processes by understanding and effectively using standardoffice equipment and standard software packages, while providing technicalguidance as needed.Intermediate Excel and WordCustomer and Market AnalysisConducts research and analyses data with guidance (but not constantsupervision) to develop a comprehensive understanding of customerand market conditions that enables maximum return on investments.Knowledge of products and brand.ComplianceProvide technical guidance when required to achieve full compliance withapplicable rules and regulations in management and/or operations.Policy and proceduresProvide technical guidance when required to develop, monitor, interpret andunderstand policies and procedures, while making sure they matchorganisational strategies and objectives.ReportingApplies comprehensive knowledge and skills to work independently whileproviding guidance and training to others on creating relevant, lucid and effectivereports.Data ManagementApplies comprehensive knowledge and skills to work independently whileproviding guidance and training to others on acquiring, organising, protectingand processing data to fulfil business objectives.Learning and Talent DevelopmentProvide technical guidance when required to motivate all employees to learn,grow and develop so that they can obtain the knowledge and experience theyneed to help the organisation reach its goals.Builds RapportWorks without supervision and provides technical guidance when required toquickly and effectively establish trust within the buying centres in the client'sorganisation.Confirms understanding, incorporates client's point of view, Provides relevantcontext, reinforces professional capability, Respects the client's time, Showsempathy with buyer's circumstancesAnalytical SkillsWorks without supervision and provides technical guidance when required onsupporting research schedules using appropriate analytical processes andprocedures.EDUCATION General Education
  • Matric / Grade 12 or SAQA Accredited Equivalent (Essential)
  • Regulatory Exam
  • 5 (Advantageous); NQF5 Wealth Management qualification (Advantageous)
  • Class of Business (Advantageous)
  • RE1 and ASISA Claims Assessor Course (Advantageous)
EXPERIENCE General Experience
  • 5 or more years funeral supervision experience within the long-term insurance
  • industry (Essential)
  • 3-5 years junior claims management experience in the life
  • underwriting environment (Advantageous)
  • relevant medical insurance knowledge (Essential)
Managerial Experience
  • 1 or more years' experience of supervising and directing people and other
  • resources to achieve specific end results within limited timeframes (advantageous)
ADDITIONAL INFORMATION*SAQA Accredited Equivalent - it is the onus of the applicant to provide 1Life and its subsidiaries with certified evidence that their qualification(s) meet the equivalent NQF level required for this role at time of application. *Financial Sector Conduct Authority (FSCA) competency requirements: FAIS recognised qualifications / Regulatory Examinations / Class of Business Certification and / or CPD according to your DOFA (where applicable). As a registered Financial Service Provider, we are mandated to ensure that all our representatives are and remain fit and proper at all times. By applying for this role, you consent to having your relevant qualification and or accreditation or confirm that you are working towards meeting the competency requirements. You further consent to the relevant information being verified.

1Life Insurance