Job Description: Long-term Insurance Dispute Resolution Technical LeadPosition 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: 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.Documentation Handling: Ensure that all relevant documents, including physical copies and supporting materials, are properly uploaded and maintained for each complaint.Process Improvement: Identify opportunities for enhancing client service and operational processes by analyzing service gaps and compliance issues, and recommending actionable solutions.Stakeholder Liaison: Maintain communication with relevant business units to ensure timely and satisfactory responses to complaints, while monitoring the progress of each case.Risk Mitigation: Proactively highlight any reputational or financial risks associated with service gaps or non-compliance, and develop strategies to address these issues.Regulatory Compliance: Stay informed about changes in insurance legislation and industry standards, participating in ongoing education and training to maintain expertise.Knowledge Sharing: Foster a culture of knowledge sharing by keeping the team updated on regulatory changes and best practices within the industry.Client Communication: Ensure that clients receive timely updates and responses regarding their complaints, and provide necessary documentation to support claims processing.Relationship Building: Establish and maintain effective relationships with both internal teams and external stakeholders through workshops and discussion forums.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 CertificateAdvanced Diplomas/National 1st DegreesPreferred Qualification: Admitted AttorneyPreferred Certifications: RE 5 CertificationExperience: Minimum of 5 years experience as a Long-term Insurance Ombudsman Liaison specialist with a focus on dispute resolution.