Gap Claims Operations Team Leader - Westville, South Africa - Kaelo

Kaelo

Verified Company

Westville, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Company Description

Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change.

Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa - products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.

Job Description:

The Gap Claims Team Leader manages both the authorisation of claims and has specialised knowledge of the claims environment.

There is a strong focus on accurately and efficiently resolving the claim received whilst ensuring exceptional customer service and satisfaction.

The claims team leader has the responsibility of ensuring that the claims team carry out their responsibility while keeping the team motivated and efficient.

The claims team leader works closely with the Claims Manager and Claims Operations Executive.

KEY OUTCOMES (not limited to) Level 4 and 5 process elements
Reporting and Managing Key Team Deliverables
Monitoring of the daily dashboard to ensure adherence to SLA
Monitoring the teams accurate and efficient processing of claims
Contribute towards continuous improvement and innovation at process and procedure level
To ensure that all claims processing and queries are attended to accurately and within the agreed turnaround time
Monitoring of daily performance statistics and workforce management
Daily claims focus and work allocation
Assist clients with escalated queries and provide suitable query resolution
Accurate completion of people management tasks on a daily basis
Ongoing feedback to clients
People and Team Management
People and team management
Ensuring participative leadership and strong communication within the team
Collaboration with all business areas
Coaching and peer to peer learning
Knowledge and Quality Management
Developing of all employees and ensuring smooth onboarding for new employees.
Review, maintenance and improvement of all processes and document management
Quality assurance and trending
Contribute toward risk management

Qualifications:

SPECIAL REQUIREMENTS
Communication skills
Analytical ability
Time management
Customer focus
Ability to adapt to an ever changing environment
Cope well under pressure

PERSON DETAILS:

WORK EXPERIENCE

REQUIRED
Insurance industry experience
Claims experience
Team management and leadership experience

PREFERRED
Health Insurance industry

EDUCATION:

QUALIFICATIONS:

ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED
Grade 1- Matric
RE 5
Accreditation would be advantageous (a minimum of 120 credits)

PREFERRED
Accreditation would be advantageous (a minimum of 120 credits)

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED
Computer literate, including Microsoft Access
Gap Claims knowledge

PREFERRED
Additional Information

Personal Attributes