Claims Assessor
Claims Assessor
Posted on :
05-01-2025
Employer Active
1 Vacancy
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Job Description
Are you looking for a new permanent career with opportunities to progress within a global financial business
Our client based in Bristol City Centre is looking for a Clinical Claims Assessor to join there team.
Summary:
- dependent on experience
- Bonus of 812%
- Monday to Friday 9am5pm
- Permanent Contract
- Hybrid working available
- Lots of company perks and benefits enhanced leave etc
- Great bonus and pension structure
Job Summary:
To assess and accurately validate Clinical Claims associated to all individual and corporate insurance products provided through the Protection business. Ensuring only valid claims are paid in accordance to the financial liability associated to the insured risk.
Job Duties:
- Independently set up claims to accurately reflect the financial liability.
- Ensure escalation controls and checking procedures are followed for high benefit claims that exceed financial retention limits or personal authority levels.
- Follow company procedures to accurately check eligibility of claimants to ensure only those where a financial liability exists progress to full claim assessment.
- Analyse and appraise all information received and request gaps in medical and nonmedical information from appropriate sources.
- Ensure inconsistent information is clarified through effective research and questioning techniques.
- Ensure accurate decisions are reached so that only valid claims are paid according to the definitions within the appropriate Policy Terms and Conditions.
- For Clinical IP claims where recovery is expected Conduct regular reviews of evidence to appraise claim validity and secure safe returns to work so that benefits are only paid for the period the claim is valid.
- For Clinical IP claims where recovery is not expected (classified as Xfiles) Check health and employment status in line with documented process and revalidate claims at appropriate times through to the Policy cease date.
- Demonstrate an engaging and outstanding level of customer service
- Recognise claimant vulnerabilities and ensure customer service skills reflect a considered course of action.
- Ensure all claim activity corresponds with Risk Compliance and Legal guidelines and thorough audit trails reflect the highest levels of integrity required in a claims environment
- Handle medical records and Personal Sensitive information in line with the company procedure.
Requirements
What we need from you:
- Claims Assessment Experience.
- Customer Service Experience.
- Attention to detail in order to appropriately assess risk.
- Ability to work in a customer deadline driven environment.
- Knowledge to handle sensitive data appropriately.
- Good Excel and data skills.
- Ability to work as part of a team towards shared targets.
- Excellent communication skills to support internal and external customers.
Benefits
- Hybrid Working Options
- 30 days holiday Bank Holidays
- Bonus
- Pension
- Private Medical Insurance
- Life Insurance
- Lots of Perks and Discounts
Able to underwrite Health Declarations Understand the underwriting manuals and processes. Understand the protection products which require underwriting input. Customer focussed approach with an ability to think outside of the norm and challenge existing processes. Ability to communicate with all types of customers and contribute to a team delivering service excellence. It would be desirable to have GR1 or other industry recognised qualifications.
Employment Type
Full Time
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