Job Description

Claims Team Leader is responsible for overseeing a team of claims professionals, ensuring that claims are processed efficiently, accurately, and in compliance with both internal guidelines and regulatory standards. This role involves managing team. performance, providing coaching and support, and ensuring a high level of customer Managing the performance of a team of claims agents, the role includes supervising daily operations, ensuring that claims are handled accurately and in a timely manner, and supporting the team in resolving complex claims. The Claims Team Leader focuses on meeting performance targets, enhancing team productivity, and maintaining a high standard of customer service.

Key Responsibilities:

Lead, coach, and support a team of claims adjusters, examiners, and specialists to ensure efficient claims processing. Set performance targets and monitor the team's progress in meeting service level agreements (SLAs) and quality standards. Conduct regular team meetings and one-on-one sessions to provide feedback, discuss performance, and address any issues. Assist in hiring, training, and developing new team members to ensure they meet the organization's standards.
Supervise and coordinate the daily activities of the claims team, ensuring that claims are processed in a timely, accurate, and compliant manner.

Oversee the handling of more complex or high-value claims, providing guidance to team members on strategy and decision-making. Ensure all claims are processed in accordance with company policies, legal requirements, and industry regulations. Implement and monitor quality control procedures to ensure that claims are processed according to industry best practices. Work with the compliance team to stay updated on any changes in laws or regulations that may affect claims handling. Address any compliance issues or discrepancies, ensuring that corrective actions are taken promptly. Ensure that the claims team delivers high-quality customer service, providing timely and accurate responses to clients. Handle escalated client issues or complaints, working to resolve them efficiently and to the client's satisfaction. Ensure that claims are processed fairly and transparently, balancing customer needs with company policies. Use performance data to recommend and implement process improvements that increase efficiency and reduce costs. Work closely with other departments such as underwriting, customer service, risk management, and legal to ensure seamless claims handling. Collaborate with other team leaders or managers to ensure consistency in claims handling processes and to share best practices. Provide support to team members in resolving more difficult or complex claims, offering guidance on appropriate actions and strategies. Make decisions on high-value or sensitive claims in accordance with company policies or escalate to senior management when necessary. Address process challenges or bottlenecks to ensure the smooth flow of claims processing.

Educational Qualifications

Matric (Grade 12) -

mandatory

A relevant diploma or degree in: Insurance (Certificate in Short Term Insurance ) Business Administration, Risk Management, or a related field Regulatory Exam (RE5) FAIS compliance - where applicable

Experience

Minimum 3-5 years

of experience in a claims environment (motor, non-motor, or both)

At least

1-2 years

in a

supervisory or leadership

role within a claims team

Proven experience in:

o Claims processing and adjudication

o Managing workloads and team performance

o Customer and broker engagement

Strong

leadership and team management

skills

Excellent

claims technical knowledge

Knowledge of policy wording, claims procedures, and relevant legislation (e.g., TCF, POPIA, PPRs)

Proficient in

claims systems

(e.g., TIA, Guidewire, ClaimView)

Analytical and decision-making

ability

Conflict resolution

and interpersonal skills

Excellent

communication skills

(written and verbal)

High level of

accuracy

and attention to detail

Ability to work under pressure and meet deadlines

Job Type: Full-time

Work Location: In person