Long-term Insurance Dispute Resolution Technical Lead

SUMMARY:
Elevate Your Career: Technical Lead for Insurance Dispute Resolution!

POSITION INFO:

Job Description: Long-term Insurance Dispute Resolution Technical Lead

Position Overview: The Long-term Insurance Dispute Resolution Technical Lead is a key role responsible for managing the dispute resolution process related to long-term insurance. This position involves representing the organization in interactions with various Ombudsman offices and regulatory bodies, ensuring compliance and effective handling of complaints.

Key Responsibilities:

1. Dispute Management:

   • Oversee the recording and tracking of all complaints in the Client Relationship Management (CRM) database, ensuring all details are accurately documented for reference.

2. Documentation Handling:

   • Ensure that all relevant documents, including physical copies and supporting materials, are properly uploaded and maintained for each complaint.

3. Process Improvement:

   • Identify opportunities for enhancing client service and operational processes by analyzing service gaps and compliance issues, and recommending actionable solutions.

4. Stakeholder Liaison:

   • Maintain communication with relevant business units to ensure timely and satisfactory responses to complaints, while monitoring the progress of each case.

5. Risk Mitigation:

   • Proactively highlight any reputational or financial risks associated with service gaps or non-compliance, and develop strategies to address these issues.

6. Regulatory Compliance:

   • Stay informed about changes in insurance legislation and industry standards, participating in ongoing education and training to maintain expertise.

7. Knowledge Sharing:

   • Foster a culture of knowledge sharing by keeping the team updated on regulatory changes and best practices within the industry.

8. Client Communication:

   • Ensure that clients receive timely updates and responses regarding their complaints, and provide necessary documentation to support claims processing.

9. Relationship Building:

   • Establish and maintain effective relationships with both internal teams and external stakeholders through workshops and discussion forums.

10. Reporting:

    • Respond promptly to inquiries from the Ombudsman and regulatory bodies, ensuring that all resolutions are completed within stipulated deadlines.

Requirements:

• Essential Qualifications:

  • Matric / Grade 12 / National Senior Certificate
  • Advanced Diplomas/National 1st Degrees

• Preferred Qualification:

  • Admitted Attorney

• Preferred Certifications:

  • RE 5 Certification

• Experience:

  • Minimum of 5 years’ experience as a Long-term Insurance Ombudsman Liaison specialist with a focus on dispute resolution.