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| POSITION DESCRIPTION | GENERAL INSURANCE INDUSTRY NOVEMBER 2008 |
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National Claims Manager - Health |
| Position Code: | 4205 | | Career Level: | 6 |
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Responsible for
Establishing, monitoring and controlling claims management systems, standards and techniques to ensure claims, functional and operational units provide an effective, economic and prompt claims management service. |
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Reports To
General Manager/Chief General Manager |
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Supervises
Claims Supervisors/Team Leaders |
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Main Activities
Ensuring that the company’s overall business development and profit objectives are met through the development and implementation of appropriate claims management strategies and plans.
Contributing to the profitability of the company’s general insurance business by establishing broad policy and procedures.
Providing the company with well motivated, trained and experienced claims management personnel.
Monitoring ongoing insurance trends and recommending and/or implementing appropriate strategies to address emerging issues.
Participating in industry-wide forums to represent the company in such matters and to ensure the company remains well informed.
Monitoring and controlling ongoing claims administration to ensure efficient and appropriate handling of claims and ensuring that recoverable income is maximised through efficient administration and follow-up.
Approving substantial claims within appropriate authority levels.
Developing and implementing policy with regards to fraudulent claims.
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Key Skills
Broad knowledge of insurance industry and claims processes
Ability to provide leadership guidance and functional support by identifying ongoing training needs and implementing appropriate human resources strategies.
Must be able to negotiate at high levels and have superior communication skills
Ability to maintain a high level of quality in all claims administration activities ensuring that settlement times and complaint levels are minimised and that customer surveys provide positive indication of ongoing success.
Sound knowledge of claims administration procedures and related systems
Develops and implements appropriate claims management strategies and plans
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| Internal Contacts |
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| External Contacts |
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Typical Experience
Tertiary and ideally post graduate qualification and 15 years management experience. |
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