Posted: 12 March
Offer description
Claims Administration Assistant
The primary objective is to support the business in achieving all KPIs set by delivering excellent claims administration service throughout the lifetime of the products and the client relationship.
To manage all claims administration tasks efficiently by applying best practice approach where possible in order to meet competency levels and qualifications required to work in a busy group risk function under MCC guidelines.
Key Responsibilities
Customer Relationships
* Maintain effective broker relations, providing customers with prompt, accurate and comprehensive replies.
* Deliver high-quality customer communications.
* Initiate day-to-day communication by telephone/email with Irish and international brokers, clients, members, claimants and medical professionals.
* Develop and maintain strong relationships with internal departments including sales, pricing, finance, claims, underwriting, compliance, risk and marketing.
* Active participation in team meetings, one-to-ones, client/broker meetings.
Maintain Key Relationships (Internal & External)
* Build and maintain effective working relationships with Utmost colleagues in multiple jurisdictions, Morgan Ash, Advance Medical and all external service providers to cover claim management operational issues.
* Ensure adherence to all operational procedures in the multi-jurisdictional offices.
* To ensure communications between operational staff and related Utmost offices is working effectively and without duplication of effort.
* Actively participate in the claims team weekly meeting.
Customer Service
* Ensure all internal and external service levels are adhered to.
Claims Administration & Management
* Deliver optimum efficiency and high-quality administration service at all times.
* Resolve client queries in a prompt and sensitive manner.
* Adhere to reinsurer guidelines and treaty rules.
* Be resilient in facing day-to-day work challenges and focused on achieving desired results. Maintain claim database and post logs.
* Adherence to all procedures and operational risk.
* Request medical information or arrange medical examinations as required.
* Approve and pay invoices on a weekly basis.
* Provide relevant weekly and monthly information to finance department.
* Run weekly payroll reports for claims expenses incurred in a timely manner.
* Continuously monitor independent consultants quality, fees, report turnarounds and performance.
* Provide feedback to head of claims and technical claims manager on positive and negative quality identified.
Quality Control
* Adhere to process controls on all aspects of claims administration to ensure high standards are set and maintained.
* Streamline the delivery of administration function to obtain maximum efficiency.
* Ensure 100% accuracy on data input for delivery of benefit payrolls for UCS claims department.
* Identify trends and propose solutions to increase accuracy and strengthen controls.
* Instil 100% accuracy philosophy on all aspects of claims administration.
* Comply with all fiscal, legal and regulatory obligations e.g. GDPR, CPC.
Key Requirements
Knowledge – Experience or Qualifications
* Previous experience in an office-based environment.
* Business-related degree essential.
Skills
* Comfortable using Excel and Word.
* Strong organisational skills.
* Solid communication and relationship management skills.
Behaviours
* Ability to work toward tight deadlines within a fast-paced environment.
* Open to continuous development regarding industry educational qualifications – DLDC Diploma (III) or QFA (LIA).
