Team Leader

The Team Leader will support the team by maintaining a high level of quality and accuracy, from claim opening to claim settlement, while ensuring a superior level of Customer Experience in all interactions.

Position Purpose and Description

This position exists to lead a team of Claims Assessors specializing in the opening and assessment of insurance claims. The Team Leader will support the team by maintaining a high level of quality and accuracy, from claim opening to claim settlement, while ensuring a superior level of Customer Experience in all interactions. The Team Leader will be responsible for tracking individual performance, communicating team objectives and monitoring service level agreements. The Team Leader will also identify opportunities for Training and employee growth and will propose improvements to existing processes and tools.

Expected Outcomes & Actions – Weighting

1.               Meet or Exceed Internal and External Client Expectations (40%)

1. Ensure prompt, accurate, and complete processing of information;
2. Establish and organize work and resources to effectively meet service standards;
3. Produce and analyze daily operating reports comparing actual performance vs. targets/goals;
4. Provide feedback to management on trends and steps taken/to be taken;
5. Provide support internally and with corporate clients for policy intent and claims processing;
6. Monitor quality and service levels constantly in order to ensure a positive customer experience;
7. Develop guidelines and processes aimed at ensuring we are delivering superior service to our clients;
8. Plan and organize department activities, priorities, special projects to achieve maximum efficiency and improved service;
9. Identify, analyze and solve problems; involve appropriate parties, open to alternative solutions and foresees consequences;
10. Resolves customer issues that cannot be solved by the team members, seeks input from other departments as required, but ensures the tools and authority levels are in place to get the job done;

2.               Optimize Claims Processing (30%)

1. Identify, analyze and solve problems and collaborate with internal departments to improve processes and resolve issues;
2. Inform superior and other department heads of critical issues in a timely manner;
3. Ensure policy intent, processes and guidelines are clear and adhered to;
4. Identify improvements to processes on an on-going basis with the aim of cutting costs and improving efficiencies;

3.               Develop and Lead a High-Performance Team (30%)

• Recruit high performing individuals who will add value to the department;
• Develop employees through training, coaching, motivation, evaluation and clear communication of expectations on an on-going basis;
• Retain a high-quality staff through rewarding and recognizing high-performers;
• Deliver consequences to employees who are not delivering the desired results in a timely fashion;
• Set service targets, ensure they are properly communicated to employees and provide employees with the necessary tools in order to reach these goals;
• Establish and maintain tracking of metrics within the department to ensure productivity and to provide feedback to employees on a continuous basis;
• Deliver audit results to employees on a continuous basis;
• Provide a positive and stimulating working environment for the employees through communication and motivation;
• Tie individual goals and tasks to the department's objectives to help employees view their work and contributions as important;
• Manage and promote change within the team.

 Major Challenges

• Accountable to deliver multiple services during extended hours;
• Managing employee workload through fluctuating claims volumes;
• Diversity of policies;
• Clarifying policy intent;
• Complexity of tools and non-medical claims process;
• Motivation and employee development.

Major Job Accountabilities

• Ensure delivery of prompt, accurate and timely policy and claim status information;
• Provide customer service support while consistently delivering excellent customer service;
• Ensure service level agreements are met or exceeded;
• Ensure delivery of prompt, accurate and timely claims processing;
• Ensure customer service excellence delivery throughout claims process.

Success Measures

• Team meets their mandated expectations for service and accuracy;
• Meeting established service levels;
• Meeting productivity goals;
• Employee Engagement.

Attributes, Experience & Qualifications

• Minimum of 1-3 years of experience in claims processing, insurance, or customer service, with experience in a supervisory or leadership role. (Preferred)
• Experience with claims management software and proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
• Strong leadership skills with the ability to coach, mentor, and develop a high-performing team.
• Ability to inspire, engage, and motivate employees to meet and exceed performance targets.
• Strong analytical and problem-solving skills to assess claims and improve operational efficiency.
• Ability to track and interpret performance metrics to make informed decisions.
• Ability to liaise effectively with internal and external stakeholders.
• Proactive mindset towards optimising claims processing workflows.