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Job Description

Purpose of the Job

The Senior Specialist for the Claims (CFR) Oversight and Monitoring Team is responsible for conducting in-depth reviews and assessments of short-term commercial and personal insurance processes. This role involves analyzing complex data and ensuring compliance with regulations and company standards.

Key Responsibilities

Review Execution

Independently plan, execute, and document reviews and assessments.Analyze complex insurance processes and identify areas of improvement.Ensure reviews are conducted in accordance with industry regulations.

Quality Assurance

Review and validate review findings for accuracy and compliance.Collaborate with the team leader to implement corrective actions.Monitor and report on performance metrics.

Stakeholder Communication

Communicate review results and findings to relevant stakeholders.Collaborate with other departments to address process-related issues.

Compliance and Risk Management

Stay up-to-date with insurance industry regulations in South Africa.

Experience, knowledge & skills required

Diploma or degree in Audits, Business, Finance, or a related fieldMinimum 2-3 years of experience in insurance industry auditingTechnical claims and underwriting experience advantageousStrong knowledge of South African insurance regulationsStrong analytical and problem-solving abilitiesAttention to detail and a commitment to accuracyEffective communication and interpersonal skillsProficiency in audit software and Microsoft Office Suite

This role assists Risk Officers to ensure that risk processes (risk assessment, identification, management, reporting & optimisation) occur at business unit level and is individually accountable for achieving results through own efforts.

ResponsibilitiesFinancial Management and Control

Track progress against budgets within established finance systems, and report variances to more senior colleagues.

Data Collection and Analysis

Conduct research using primary data sources, and select information needed for the analysis of key themes and trends.

Policies and Procedures Development

Contribute to the drafting of policies, procedures, and related guidelines within an area of expertise to meet defined key principles and ensure compliance with external requirements.

Organizational Risk Management

Ensure the organization is not exposed to undue risks by using risk management systems to achieve specific goals within a designated area of the business.

Risk Scenario Modeling

Analyze and assess the risks associated with products, individual applications, new business areas, and the market to quantify risk and ensure it is within the agreed risk appetite.

Recommendations

Advise others on how to design new processes and systems that meet professional standards.

Insights and Reporting

Contribute to the preparation of various data and analytics reports.

Document Preparation

Organize and prepare complex documents using a variety of applications for technology devices, such as standard office software. Also responsible for gathering and summarizing data for special reports.

Operational Compliance

Identify, within the team, instances of noncompliance with the organization's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these instances and escalating issues as appropriate.

Personal Capability Building

Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching; gain or maintain external professional accreditation, where relevant, to improve performance and fulfill personal potential. Maintain an in-depth understanding of technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.

Skills

Action Planning, Analytics Software, Budget Management, Computer Literacy, Data Analysis, Database Reporting, Data Compilation, Data Controls, Data Interpretations, Evaluating Information, Management Reporting, Numerical Aptitude, Report Review, Solution Analysis

Competencies

Business InsightCommunicates EffectivelyCourageDecision QualityEnsures AccountabilityFinancial AcumenInstills TrustManages Complexity

Education

NQF Level 7 - Degree, Advance Diploma or Postgraduate Certificate or equivalent

Closing Date

25 March 2025 , 23:59

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

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