The Kaelo Health Claims Team Leader manages both the authorisation of claims and has specialised knowledge of the claims environment. There is a strong focus on accurately and efficiently resolving the claim received whilst ensuring exceptional customer service and satisfaction. The claims team leader has the responsibility of ensuring that the claims team carry out their responsibility while keeping the team motivated and efficient. The claims team leader works closely with the Claims Manager and Claims Operations Executive.KEY OUTCOMES
Determines claims operational strategies by conducting:
- Assessments
- Performance Review
- Capacity Planning
- Productivity Quality
- Customer service standards
Maintains and improves claims operations by monitoring system performance
Accomplishes people objectives by recruiting, selecting, training, assigning, couching, counselling and disciplining employees.
Pre-pare claims performance report by collecting, analysing, and summarising data and trendsReporting and Managing Key Team Deliverables
Monitoring of the daily dashboard to ensure adherence to SLA
Monitoring the teams accurate and efficient processing of claims
Contribute towards continuous improvement and innovation at process and procedure level
To ensure that all claims processing and queries are attended to accurately and within the agreed turnaround time
Monitoring of daily performance statistics and workforce management
Daily claims focus and work allocation
Assist clients with escalated queries and provide suitable query resolution
Accurate completion of people management tasks on a daily basis
Ongoing feedback to clientsPeople and Team Management
People and team management
Ensuring participative leadership and strong communication within the team
Collaboration with all business areas
Coaching and peer to peer learningKnowledge and Quality Management
Developing of all employees and ensuring smooth onboarding for new employees.
Review, maintenance and improvement of all processes and document management
Quality assurance and trending
Contribute toward risk management