Specialised Claims (Investigation) Manager

Introduction Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members. Through our own network of advisers or via independent brokers and utilising new platforms Momentum Metropolitan provides practical financial solutions for people, communities and businesses. Visit us at www.momentummetropolitan.co.za

Disclaimer As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose To effectively manage the specialized claims (investigations) department. This includes but is not limited to the management of processes, procedures, systems, and leading of people to minimize claims leakages.

Requirements

• Bachelors degree in Forensic Investigations or related field.

• 8-10 years' experience in short-term insurance claims.

• Minimum 5 years' experience in fraud investigations or forensic investigations.

• At least 3 years in a leadership or management role.

• Experience managing complex insurance fraud investigations.

Duties & ResponsibilitiesOPERATIONALMANAGEMENT

• Ensure that claims to be investigated are, identified, conducted, and reported on, in line with applicable policies, procedures and legislation

• Establish and maintain positive Stakeholder relations to foster good internal and industry partnerships

• Plan and continuously monitor and evaluate systems and procedures with the aim of improving quality of service to customers and all stakeholders

• Manage the preparation and presentation of departmental and group reports as required (weekly, monthly, quarterly.)

• Track the attainment of departmental strategic goals and take the necessary steps to achieve efficiencies

• Monitor and review performance data of department

• Plan and execute budget controls in line with appropriate policies and procedures and for the benefit of the department and the organization at large

• Execute business decisions that are in line with the organizational values of Innovation, Accountability, Integrity, and Teamwork

• Handle client and broker complaints in an efficient, effective, and professional manner

• Be the custodian of Momentum Insure’s Claims Philosophy principles

PEOPLE****MANAGEMENT

• Create a conducive working environment and a culture that aligns to the organizational values

• Ensure that all grievances and issues of noncompliance to operational and organizational policies and procedures, are dealt with speedily and decisively

• Maintain open communication at all levels, including but not exclusive to, one-on-one communication, team/departmental communication and as required to senior structures of the organization

• Plan staffing levels to ensure optimal levels of productivity and efficiencies

• Collaborate with the Human Capital department to ensure that recruitment processes are followed in accordance with the required policies, procedures, and legislative requirements

• Manage people performance and ensure that formal and informal feedback is provided on a regular basis to individual and teams and in line with the organization's performance policies and procedures

• Coach, mentor and ensure people development to maximize operational efficiencies and in line with People Development policies and applicable legislation

• Manage the resolution of identified risks and apply controls to eradicate/minimize failures in the investigations processes

Competencies

• Integrity and ethics.

• Analytical thinking.

• Decision-making.

• Attention to detail.

• Leadership and people management.

• Problem-solving.

• Customer focus.

• Resilience and adaptability.

• Negotion Skills

• Excellent communication skills (written and verbal)

• Interpersonal Skills

• Financial & Business acumen