Claims Operation Manager, South Africa

The Claims Operations Manager – South Africa, will report to the EMEA Head of Claims Operations with a matrix to the South Africa Head of Claims.

This role will be responsible for process optimization & continuous improvement, claims governance & compliance, strategic execution, project delivery, claims system initiatives and where required, coordinate with TPA management, vendor management, fraud & recovery, business intelligence and Global Quality Assurance.

Key Responsibilities For This Role Include

• Pursue continuous improvement by challenging current processes and ways of working to identify improvement opportunities whilst aligning to broader regional, international and global priorities.
• Support in effectively delivering improvement initiatives and project delivery including Global GI Claims Strategic Initiatives, International projects, regional projects, local projects, and IT initiatives ensuring clear prioritization and alignment.
• Work collaboratively with the leadership team across South Africa Claims and Claims IT to identify and implement further opportunity for enhancements to segmentation and our digital capabilities.
• Develop and manage performance metrics for claims team in collaboration with South Africa Head of Claims, defining operational targets and provide continuous feedback to achieve them.
• Monitor claims team activity to identify trends and opportunities for improvement, including claims initiatives that will improve operational efficiencies, customer journey or indemnity and expense spend improvement.
• Create an operating reporting framework and report claims performance to stakeholders – KPI/metric reporting in place monthly/quarterly and distributed to owners for review and analysis.
• Support effective claims business reporting for South Africa and region. Work with Business Intelligence Team to assist with internal reporting, ensure that accurate and timely reports/changes are maintained as required.
• Drive a strong control framework and lead Claims Governance & Compliance for South Africa Claims working in close collaboration with International Head of Claims Governance and Compliance.
• Implement strong first line controls for key risks identified in South Africa Claims, working collaboratively with Risk Officers, Internal Audit Group and Compliance, to continuously improve. Drive a strong risk management culture in South Africa Claims.
• Coordinate and own (where appropriate) risk event mitigation plans and resolution of internal audit action plans for South Africa Claims.
• Coordinate (where required) and perform governance oversight over key claims compliance requirements (Manager OFR, Duplicate Claims review, Duplicate Claims Payment review, Suspended / Pending Claims Review, Quarterly Reserve Review etc.) and controls (system - LoA reconciliation etc.) and escalate to senior management where required.
• In collaboration with South Africa Head of Claims and International Head of Claims Governance and Compliance, develop and maintain South Africa Claims policies, standards, and controls ensuring Claims personnel have knowledge and receive training around AIG policies, standards, and controls.
• Establish and maintain appropriate means to monitor and accommodate changes in regulatory environment that impact AIG’s compliance obligations.
• Promote various feedback mechanisms ensuring management has the necessary information needed to manage and improve performance.
• Coordinate and ensure timely and appropriate responses are provided to all regulatory, SOX, GQA, internal and external audits.
• Work with South Africa Head of Claims and leadership team across South Africa Claims to ensure that all claim employees with a reserving/settlement/payment has a Letter of Authority (LoA), system authorities are aligned to LoA and has a complete understanding of conditions contained in the LoA and the annexes.
• Work in close partnership with the Claims Operations functional leads - TPA Management, Vendor Management, Business Intelligence, GIS, GRS and GQA to deliver strong performance and oversight for South Africa claims.
• Represent South Africa Claims in committee/ meetings where appropriate.
• Provide day to day operational support for South Africa Claims Team as agreed with EMEA Head of Claims Operations.
• Drive a culture that promotes collaboration, diversity, equity, and inclusion.
  
  

Key Qualifications

The successful candidate will have proven experience in leading successful operational teams and a demonstrated ability to communicate and influence at varying levels. The individual will also have a proven track record in governance within the Insurance industry ideally within claims. In addition, she/he will have a proven track record as an exceptionally effective change agent. The candidate will possess a strong business and process mindset and change leadership skills to unify teams around common goals and drive change.

Additional Requirements Include

• Highly motivated and ability to work under own initiative and as part of a team.
• Strong background in operational management and process improvement.
• Expertise in Continuous Improvement Methodologies.
• Strong Compliance, Governance and/or audit, regulatory background. Comprehensive awareness of the Business and Regulatory environment
• Experience in building governance frameworks within a complex organization ideal
• Strong commercial mindset with a proven track record of making sound decisions backed by data
• Ideally experienced in leading client facing teams with a service delivery mindset with knowledge of consumer and commercial claims handling.
• Exceptional communication skills including the ability to develop and present clear and concise analysis and recommendations
• Proven ability to dissect complex business issues, perform research and analysis, and synthesize conclusions into a value-maximizing strategy
• Ability to connect staff both on an individual level and in large groups; capacity to enforce accountability, cultivate entrepreneurship, and learn the strengths and weaknesses to best leverage skills and nurture talent
  
  

#AIG-LI

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

Enjoy Benefits That Take Care Of What Matters

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of inclusion

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to [email protected].

Preference will be given to previously disadvantaged candidates in line with the company’s Employment Equity Plan. Specific preference will be given to people with disabilities.

Functional Area

CL - Claims

AIG South Africa