Role Purpose

To lead and manage the claims team to resolve client queries and process claims aligned with business expectations and the desired client experience.

Requirements

• Matric as a minimum
• 4 – 6 years’ Claims experience in the Medical Aid industry is essential
• 1 – 2 years’ people management experience is essential

Duties and Responsibilities

Internal Process

• Manage, monitor and control the Claims team’s delivery on Service Level Agreements made with clients.
• Manage, monitor and control the team’s execution of client claims and queries.
• Act as an escalation point to assist the Claims team in addressing client queries.
• Ensure the team’s adherence to correct procedures when following up on queries.
• Analyse the Claims Administration processes and identify opportunities for improvements; implement improvements within the Claims team.
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