Claims Manager - Kloof, Durban

An established organisation is seeking a capable and experienced Claims Manager to take responsibility for the effective running of its claims department. This position calls for a strong operational leader who can guide a team, ensure consistent service delivery, and maintain high standards of accuracy, compliance, and client care. The successful candidate will oversee the full claims cycle, manage complex matters, and contribute to ongoing improvements in processes and performance.

Key Responsibilities

Team Leadership

• Supervise, coach, and support a team of claims administrators

• Conduct performance reviews and identify development needs

• Provide guidance on complex or non-standard claims

• Ensure workloads are appropriately distributed

Operational Management

• Oversee daily claims activities to ensure timely progression and resolution

• Implement structured procedures to handle high volumes efficiently

• Identify delays or inefficiencies and introduce practical improvements

• Maintain service levels in line with organisational expectations

Quality & Regulatory Compliance

• Ensure claims are processed in accordance with applicable rules, policies, and standards

• Monitor accuracy and completeness of work through regular reviews

• Support internal and external audit requirements

• Reduce operational risk through strong controls and oversight

Client & Internal Liaison

• Serve as the key point of contact for escalated matters

• Maintain clear communication with clients and internal stakeholders

• Address concerns promptly and professionally

• Promote fair and consistent outcomes

Reporting & Insights

• Monitor trends within the claims portfolio

• Prepare performance reports for management

• Anticipate workload fluctuations and resource requirements

• Provide recommendations to improve efficiency and outcomes

Minimum Requirements

• Matric

• Relevant tertiary qualification in Business, Insurance, Risk, or a related field

• Solid experience in a senior claims environment

• Demonstrated team leadership capability

• Strong understanding of claims procedures and governance requirements

• Experience managing high workloads and competing priorities

• Sound analytical and decision-making ability

• Strong communication and stakeholder engagement skills

• High level of organisation and attention to detail