Loss Adjusting Manager

Job ID

137596

Closing Date: 07 February 2025

Job Purpose

Team Management and Oversight:

Lead and manage a team responsible for conducting contractor audits, authorizations over-mandate, claims adjustments, valuation at risk assessments, contractor rate negotiations, and handling customer complaints.

Job Responsibilities

Claim Management

Advise and provide technical support to Nedbank Insurance claims, underwriting, and complaints departments.

Minimize claim losses.

Oversee a team of desktop, field, and project management adjustors responsible for assessing, auditing, and authorizing claims in terms of allowable rates.

Risk Management

Detect and identify fraudulent activities while working closely with Group Forensic services both internally and externally to enhance fraud detection solutions.

Perform risk management functions by identifying underwriting risks and supporting the underwriting and product solution divisions to mitigate risk.

Ensure adherence to all legislative requirements and ensure the business continuity plan is updated and tested annually.

Vendor Management

Provide support to the Procurement division in onboarding and training service providers on policy wording, processes, and rates.

Monitor service providers through report writing, policy interpretation, claims costs, and service.

Maintain and sustain good business relationships between service providers, clients, and Nedbank Insurance.

Reporting And Operational Efficiency

Ensure the quality and accuracy of reports.

Highlight process inefficiencies through end-to-end process mapping.

Technical Skills And Legislation

Keep technical skills current and stay abreast of any changes to legislation.

Arbitrations, Second Opinions, And Disputes

Facilitate and assist in resolving disputes brought to the attention of the National Financial Ombuds scheme that require further investigation.

Evaluate the merit of client complaints when the client is not satisfied and resolve the complaint through inspection or clear interpretation of the policy.

Transformation

Meet transformation targets during staff recruitment, retention, and training, and use preferred suppliers.

Culture

Contribute to a culture of transformation by participating in Nedbank culture-building initiatives, business strategy, and CSI.

Develop and implement action plans to address issues raised in culture surveys.

Strategy

Support the implementation of business optimization improvement initiatives.

Review Nedbank and Business Unit plans and ensure delivered systems, processes, services, and solutions are aligned to support the achievement of the business strategy, objectives, and values.

Staffing

Implement performance agreements, ensure a clear vision, agree on goals and objectives, provide regular feedback on performance, recognize and reward achievement, and take appropriate corrective action where required.

Mentor and coach staff on identified performance gaps and agree on appropriate actions.

Ensure that team members stay abreast in their field of expertise and deliver on the expectations from stakeholders by tailoring development needs as identified.

Create an environment of teamwork and encourage participation in decision-making processes.

Identify current and future training and development needs and recruit and manage talent.

Self-Development

Identify training courses and career progression opportunities for self.

Ensure personal development plan activities are completed within the specified time-frame.

Essential Qualifications - NQF Level