Team Leader: Insurance Operations

Purpose Statement

To lead and oversee a designated team within Insurance (Credit Life Claims) to deliver ethical and efficient claims management through robust, compliantand efficient processes such as assessment and investigations in accordance with Capitec Life’s internalgeneral policies and practices as well as the respective insurance policies and external legislative framework.

Experience

• At least 3 years’  Claims Assessment experience
• 5+ years experience in an Insurance environment. 
• Minimum 3 years’ experience in leading a team in a fast moving environment.
• Applying technical expertise (operational excellence or medical know how) in respect of service delivery.
• Planning, organising and prioritising to drive delivery in an SLA focused environment.
• Process improvements and engaging with diverse stakeholders ( legal, medical professionals and clients.)

Qualifications (Minimum)

Knowledge

• People/team leadership practices and principles
• General operations management practices and principles
• Good understanding of operational and administration delivery planning and standards.
• In-depth knowledge of the insurance industry, including one or more of life, medical, funeral, disabilityclaims landscape.
• Applying an analytical approach to evaluating claims and interpreting medical/legal documents.
• Technical knowledge of insurance policies, fraud frameworks, medical terminology.
• Strong understanding of relevant legislation and medical claim assessment principles.
• Understanding of investigative tactics, tools, and methodologies.
• Understanding of operational risk
• Cultural and religious sensitivity in claims processes.
• Regulatory entities, requirements, compliance standards in an Insurance environment
• Basic data analytics
• Stakeholder engagement
• Client service and management
• HR principles and processes.
• Client service principles and practices.

Conditions of Employment