Head of Claims | Centurion

In brief

**Overview** This role is for a Head of Claims at PSG Konsult in Centurion. It involves leading the claims function, developing and executing claims strategy aligned with business and insurer objectives, and managing claims management teams. The Head of Claims will also act as a member of the executive leadership team, contributing to broader business strategy, and will be responsible for maintaining operational performance, managing insurer and value chain partner relationships, and ensuring governance, risk management, and compliance within the claims environment. **What you will do** * Maintain relevance of the STA Claims SOP by applying regular updates * Ensure adherence to STA Claims SOP by Claims area way of work, process adherence, JIRA usage, policy admin system usage * Ensure that the ratio of unanswered calls / total calls is less than 3% * Manage claims complaints within budgeted ratio for financial year (e.g., 15 per 1000 claims) * Oversee/manage/handle escalations from Advisers, clients and associated value chain parties * Ensure SLA Adherence - Average 95% * Ensure the number of Reworks / Total number of claims is not more than 3% - Team Average * Ensure that QA function executes tasks as required and that results are leveraged to improve operational performance * Ensure that Claims Manager/Team Leaders perform quality checks and drive improvement of employee quality/quality claims outcomes * Manage Insurer and value chain partner relationships * Ensure binder adherence * Assist with Binder and other audits * Develop and implement strategies that align with the company's broader goals and contribute to increased operational performance, profitability, and customer satisfaction * Maintain and report on strategic, operational and tactical plans * Oversee complaints tickets logged, classification, management of execution, ticket governance reporting Weekly, Group PMO pack reporting weekly * Develop and execute the claims strategy aligned to business and insurer objectives. * Lead and motivate claims management teams to achieve operational and customer service targets. * Drive a high-performance culture focused on service excellence and continuous improvement. * Act as a member of the executive leadership team, contributing to broader business strategy. * Manage claims performance against binder agreements and service level agreements. * Build and maintain strong relationships with insurer partners. * Report on claims trends, loss ratios, leakage, customer outcomes, and operational performance. * Ensure adherence to insurer mandates. * Ensure compliance with FAIS, PPR Policyholder Protection Rules, POPIA, Conduct Risk principles, TCF Treating Customers Fairly, and applicable insurer mandates and binder regulations. * Maintain strong claims controls and governance frameworks. * Manage fraud detection, investigation, and prevention initiatives. * Oversee audit findings and implement corrective actions, including internal audit, risk audits, or insurer binder audits. **Requirements (from the original advert)** * Bachelor’s degree * FAIS and RE compliant RE1/RE5 * KI experience and ability to be added as Key Individual of the business * Proven experience in senior management role * Proven track record of driving financial and operational performance within a division * Experience in managing Claims environments * Analytical capability and exposure to BI tools * Experience in delivering automation and optimization initiatives * Proven track record of interacting with Advisers/clients * Excellent leadership skills * Problem solving skills * Deep understanding of South African insurance market, outsource/binder environment * Policy administration system experience and a solid understanding of how insurance systems work * Experience with workflow systems and experience within a Binder Holder or UMA will be beneficial **Who should apply** The ideal candidate for this role is an experienced senior manager with a Bachelor's degree, who is FAIS and RE compliant (RE1/RE5) and possesses Key Individual (KI) experience. They should have a proven track record of driving financial and operational performance within a claims division, demonstrating analytical capability, experience with BI tools, and a background in automation and optimization initiatives. The candidate must have excellent leadership and problem-solving skills, with a deep understanding of the South African insurance market, including outsource/binder environments, and experience with policy administration and workflow systems. Beneficial experience includes working within a Binder Holder or UMA. Critical competencies include being calm under pressure, a great communicator, structured, process-driven, detail-oriented, able to execute, eager to learn, improve and optimize, possessing a strategic and decision-making mindset, customer-centric, high integrity, accountable, resilient, and having strong problem-solving ability. **Deadline** 28-Oct-2026 **Reference** Original posting: https://www.myjobmag.co.za/job/head-of-claims-centurion-psg-konsult-ltd Source: myjobmag

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