Claims Supervisor, Transpharm Pretoria - Shoprite Group

Purpose of the Job

Overseeing all employees in the Receiving Claims department to make sure daily goals are met. Activities related to claim processing and follow-up are under supervision and in accordance with relevant policies and procedures.

Job Category: Pharmaceutical

Job Objectives

• Direct supervision of the day-to-day activities in the department to ensure that claims are resolved within the required service level agreement.
• Maintaining and recording claim information, including details about the situation that resulted in the claim, dates of service rendered, and other relevant information.
• Act as an intermediary between Transpharm and client and timeously relay communication, requests and documentation.
• Follow the recoveries process, and diaries follow-ups and keep all stakeholders informed.
• Continuously monitor and initiate claims improvement processes and policies.
• Ensure compliance to contracted service levels and optimised processes.
• Manage internal and external relationships.
• Manage loss costs and loss expenses.
• Frequently communicate with all appropriate parties involved with the claim.
• Regularly review system reports, and respond promptly if necessary to resolve queries in a reasonable timeframe and to escalate where necessary.
• Create and maintain reports for submission to management.
• Checking whether calculations are correct, duplicate invoices are not being passed.

• Dealing with payment, debit note queries and ad hoc queries.
• Keep internal systems and records up to date at all times.
• Keep relevant internal stakeholders up to date on the progress of claims.
• Make an assessment of claims validity and estimate value and administer claims.
• Responsible for training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
• Continually review and measure team activities against targets, standards and service levels, agreeing and taking actions to improve capability and performance so that the team achieves its maximum potential.
• Perform personnel administration when necessary.
• Ensure that staff comply with health and safety policies and procedures.
• Accountable for keeping the department organized, conducting investigations, and enforcing all warehouse systems, processes, and procedures

Qualifications

Essential

• Matric qualification

Experience

Essential

• 3 - 5 years of experience working in a warehouse environment in a similar role
• 2 - 3 years of experience working as a supervisor

Knowledge and Skills

• Highly effective supervisory skills and techniques.
• Strong numerical skills.
• Diligently attends to details and pursues quality in accomplishing tasks.
• Develops fresh ideas that provide solutions to all types of workplace challenges.
• Excellent communication and interpersonal skills.
• Strong organisational and time management skills.
• Hands-on commitment to getting the job done.
• Knowledge of warehouse systems such as Pos-i-Till and MS Office proficiency.
• Proven ability to direct and coordinate operations.