Claims Team Leader – Medical Aid (Johannesburg)

About the role

The Claims Team Leader will head the medical claims team for a leading medical aid provider in Johannesburg. The role ensures accurate, timely processing of medical claims and delivers exceptional service to clients and healthcare partners.

Key responsibilities

• Oversee end‑to‑end processing of medical claims and related client queries.
• Ensure claims are handled within agreed turnaround times and quality standards.
• Act as escalation point for complex claims and unresolved issues.
• Monitor workflow distribution, productivity, and service‑level compliance.
• Identify operational inefficiencies and drive process improvements.
• Provide regular performance reporting and stakeholder feedback.
• Lead, coach, mentor, and develop Claims Administrators and support staff.
• Conduct performance reviews, manage attendance, and promote a high‑performance culture.
• Maintain compliance with company policies, industry regulations, and service agreements.

Required profile

• National Senior Certificate / Matric.
• 4–6 years experience in medical claims management.
• 1–2 years people‑management experience.
• Proven experience in the medical aid industry.
• Strong leadership, analytical, and problem‑solving abilities.
• Excellent customer service and stakeholder management skills.
• Ability to work under pressure and meet deadlines.
• Outstanding written and verbal communication.
• High attention to detail, organisational and administrative competence.
• Professional, resilient and results‑driven attitude.

Required skills