GAP Death claims QA; Complaints and Training specialist (Cape Town based)

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Job Description

Performs routine administrative duties such as drafting correspondences, scheduling appointments, organising and maintaining data, as well as assisting internal and external stakeholders

Job Description Summary  

Provides specialist operational support across GAP quality assurance, complaints management and training. The role is responsible for strengthening quality controls, monitoring complaint and service trends, supporting root cause analysis, developing learning interventions and ensuring that GAP processes are applied consistently, accurately and in line with governance, audit and customer-service expectations.

      Job Description

The successful incumbent is responsible for:

• supporting the end-to-end GAP quality assurance, complaints and training functions within the business,
• reviewing work outputs
• Providing complaint responses to all stakeholders (including regulators and internal stakeholders)
• Process adherence and customer communication to identify quality risks, training gaps and improvement opportunities,
• Supporting Team Leaders, Knowledge Management, GAP operations and other stakeholders with technical guidance, coaching, reporting and remediation actions, and
• Contributing to continuous improvement initiatives, audit readiness, governance controls and the embedding of standardised GAP processes.

Key result areas and work descriptors:

Complaints Management

• Ensure that all levels of complaints are acknowledged and responded to within SLA.
• Respond to complaints from social media, ombud , management and legal origin.
• Report into greater group complaints structure and to GAP management.
• Maintain a central complaints register to track volumes, ageing, complaint categories, root    causes, accountable owners, resolution actions and customer outcomes.
• Perform complaint investigations by reviewing case history, supporting evidence, system notes,         communication records and applicable process requirements.
• Identify complaint themes, repeat failures, service breakdowns and conduct risks, and escalate material issues for corrective action and management attention.
• Draft clear, accurate and professional complaint responses that are evidence-based, empathetic and aligned to business, legal, compliance and customer-service standards.
• Coordinate remediation actions with operations, quality assurance, training, legal, compliance and management stakeholders to prevent recurrence and improve customer outcomes.
• Prepare regular complaints MI, trend analysis and insight reports for GAP management, governance forums and broader complaints reporting requirements.

GAP Service Delivery, Complaints and Stakeholder Support

• Deals with escalated GAP client queries and complaints and supports resolution through clear investigation, root cause analysis and stakeholder follow-up.
• Responsible for supporting reputation risk management by ensuring complaint responses are accurate, professional, evidence-based and aligned to process requirements.
• Plans and performs daily specialist activities in accordance with GAP Standard Operating Procedures, quality checklists, mandates and agreed service standards.
• Takes ownership of quality-related interactions across organisational boundaries, including engagement with GAP operations, SuperFund, Claims, Finance, Compliance, Legal, Knowledge Management and Team Leaders where required.
• Keeps up to date with GAP product, process, system, governance and legislative changes and shares relevant knowledge with the team through coaching, training and process updates.

Personal Effectiveness

• Accountable for service delivery through own efforts.
• Individually accountable for managing own time, tasks and output quality for  periods of 1 day to a maximum of 3 months.
• Makes increased contributions by broadening individual skills.
• Collaborates effectively with others to achieve personal results.
• Accepts and lives the company values.

Quality Assurance

• Performs quality assurance reviews across applicable GAP work outputs, including customer communication, complaint handling, calculations, workflow actions, system updates and supporting evidence.
• Applies agreed QA methodology, sampling principles, check sheets and error classifications to support consistent and auditable quality reviews.
• Identifies QL1, QL2 and QL3 errors, complaint themes, process deviations and training gaps, and ensures these are recorded for trend analysis and management reporting.
• Provides constructive feedback, coaching input and escalation support for complex, high-risk or recurring quality matters.
• Supports the development and maintenance of QA registers, dashboards, MI packs and evidence files for audit, management review and quality forum reporting.

Training and Capability Development

• Designs, coordinates and delivers structured GAP training, refresher sessions and coaching interventions for new and existing staff.
• Develops and maintains learner guides, assessments, attendance records, training evidence and post-training feedback summaries.
• Translates QA findings, complaints, assessor feedback, audit findings and operational risks into practical learning topics and remedial action plans.
• Monitors training effectiveness through assessments, feedback forms, quality trends and evidence of improved process adherence.

Specific KRA’s

• Keeping abreast of GAP product, claims, complaints, quality assurance, training and governance developments.
• The ability to access, interpret and integrate information quickly across SOPs, claims records, complaint evidence, QA findings and system information.
• Handling of extraordinary cases, complex complaints, high-risk quality failures and urgent stakeholder escalations.
• Responsible for supporting point-of-contact resolution and liaising with other business units where necessary to finalise customer, complaint, QA or training-related matters.
• Responsible for analysing and documenting quality trends, complaint root causes, training needs and corrective actions.
• Supports and participates in the continuous improvement of GAP processes, controls, SOPs, templates, checklists and knowledge material.

• The ability to implement process controls, QA gates, complaint tracking and training interventions to reduce operational, financial, compliance and reputational risk to the business.

The successful applicant should substantially meet the following requirements:

• Produce and maintain QA, complaints and training reports, dashboards, registers and evidence files for management review and audit readiness.
• Perform ad hoc specialist tasks as requested by seniors, Team Leaders, Knowledge Management or GAP leadership.
• Produce business reports on an ad hoc, weekly, monthly or quarterly basis, including QA trends, complaint themes, training outcomes and corrective actions.
• Work actively with support areas to achieve service standards, quality targets and complaint resolution outcomes.
• Inform key stakeholders of relevant GAP product, process, legislative, audit, quality, training or complaint-related changes.
• Perform root cause analysis on errors, complaints and process failures and provide feedback to the relevant internal value chain.

• Computer literacy essential (Word/Excel/Outlook/PowerPoint) – intermediate level.
• Knowledge of GAP products, group risk benefits, claims administration, complaints handling or related retirement fund processes is advantageous.
• Experience in quality assurance, training, coaching, complaints resolution, root cause analysis or operational governance is strongly advantageous.
• Excellent written and verbal communication skills, including the ability to draft professional complaint responses, feedback notes, training material and management summaries.
• Strong interpersonal, facilitation, negotiation and stakeholder management skills.
• Able to work under pressure, manage sensitive matters and apply sound judgement in high-risk or high-impact situations.
• A passionate team player who supports a culture of quality, accountability, learning and continuous improvement.
• Must display sound planning, organising, reporting and follow-through skills.
• Able to display tact, diplomacy and empathy when dealing with complaints, coaching conversations and sensitive customer matters.
• Sound problem-solving skills with the ability to take ownership of quality issues, training gaps and complaint-related risks.
• Matric or relevant tertiary qualification.
• Strong desire to provide superior service and improve customer, intermediary and stakeholder outcomes.
• Very strong analytical and logical reasoning skills, with the ability to identify themes, risks, trends and practical corrective actions.
• Self-motivated and action-orientated, with high levels of energy and self-confidence.
• Knowledge of retirement fund administration, Section 37C, group life assurance, claims processes, audit requirements or financial services legislation is advantageous.
• At least 5 years’ retirement fund, group risk, claims, client service, quality assurance, complaints or training experience.
• System knowledge such as Compass, Chorus, EMS or other relevant claims, workflow and reporting tools is advantageous.
• Third party administration, insurance, claims or group risk experience is advantageous.
• Proven ability to work independently and proactively while maintaining accurate records and evidence.

 

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Skills

Accounting, Action Planning, Budget Management, Calendar Coordination, Computer Literacy, Data Analysis, Database Reporting, Data Compilation, Data Interpretations, Digital Literacy, Executing Plans, Management Reporting, Numerical Aptitude, Oral Communications, Report Review

Competencies

Decision Quality

Directs Work

Ensures Accountability

Manages Complexity

Optimizes Work Processes

Plans and Aligns

Tech Savvy

Education

NQF Level 4 - Grade 12, School leaving Certificate, National or Occupational Certificate or equivalent

Closing Date

09 September 2026 , 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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