Head of Research and Development
PNet (Pty) Ltd
Johannesburg, ZA
8d ago

Underwriting & Claims Process

Key Responsibilities

Stakeholder and Management Relationship

  • The incumbent will be required to maintain visibility in distribution, which includes branch visits, personal interaction with new / targeted individual top supporting brokers, query resolution
  • Provide marketing support from an R&D perspective where necessary
  • Assist the relevant stakeholders with providing expert advice and information relating to PPS benefits (i.e. PHP benefit definitions changes, Family Responsibility Rider Benefit and advise criteria for PHP)
  • The successful incumbent will do underwriting on applications and loading to applications, impairments and for different insurance products
  • Underwriting

  • Review Underwriting standards for alignment to COMPASS and reassess Underwriting milestones
  • Provide full support and management of all COMPASS initiatives
  • Oversee the Creation and updating underwriting manuals. Assist relevant stakeholders with medical problems, training medical terms and background
  • Claims

  • Assist in development of milestones for Sick pay
  • Complete review of claims manual
  • Oversee death claims Audits and ensure results are in alignment with the Underwriting standards
  • Oversee on-going management of long-term claims that are referred to the Permanent Incapacity (PI) team
  • Assist in designing and oversee implementation of payment process for long-term claims and audit the current monthly claims list
  • Assist with the development of sick pay processes
  • Examine claims and verify eligibility as well as record any medical charges and other payments or adjustments.
  • Budget and Financial Management

  • Manage the development, implementation and review the budget and collaborate with the Executive regarding the management of the budget
  • Monitor adherence to project budgets and propose cost-saving measures where appropriate
  • Manage all costs
  • Draft budgets for planned activities
  • Prepare and present financial reports
  • People Management

  • Actively manage the performance and potential of their direct team (recognises individual differences in terms of career objectives, expertise, culture, interests, and other factors to facilitate working relationships)
  • Build the capability of their direct team
  • Provide coaching and mentorship to team members to support problem solving, assess productivity and recommend changes where required
  • Create an engaged and motivated workforce within their team by ensuring the implementation of training initiatives and the establishment of an environment that fosters wellbeing, learning and development
  • Manage the IR climate of the business in conjunction with HR personnel to mitigate risk and improve employee relations
  • Prepare and participate in recruitment, talent management and succession planning activities
  • Work with HR in dealing with grievances and disciplinary issues and ensures their effective implementation and management
  • Identify, manage and resolve potential and actual conflict through effective communication and relationship building
  • Implement effective succession planning, people management, development, recruitment, and retention strategies
  • Knowledge & Experience

  • At least 10 years working experience in a similar role
  • At least 5 years’ experience in managing a Research & Development environment
  • Expert Underwriting knowledge
  • Excellent communication skills
  • Good computer knowledge - MS Outlook, Excel and Word are necessary
  • Insurance industry knowledge
  • Insurance industry regulations / codes
  • Qualifications

  • Matric (Grade 12)
  • Bachelors Degree (Science, Psychology or related)
  • Preference will be given to EE candidates

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