Role: Claims Assessor
Job Type: Permanent
Location: Remote (2 days per month onsite) – Co. Donegal
The Role
We are currently recruiting for an analytical Claims Assessor to join our client's financial services department.
The role involves the assessment of Life, Serious Illness, Bill Cover, Income Protection, Pension Life Cover, and Disability Claims & reviewing medical evidence on behalf of the Company, ensuring that all aspects of the Risk claims assessment process comply with Claims Procedures, Legal & Compliance guidelines as well as deadlines and company procedures.
In this role you will be accountable for:
* Assessing new claims and issuing relevant medical and financial requirements.
* Calculating the claim benefits owed to our customers and handling the ongoing payment of these benefits.
* Reviewing existing claims to ensure the terms for ongoing payment to our customers continue to be met.
* Corresponding with Advisors, Employers, Claimants, Reinsurers, Legal Representatives, Next of Kin, and Doctors.
* Developing a high level of technical and medical expertise.
* Building and maintaining effective working relationships with various partners.
* Supporting and training more junior claims staff.
Key responsibilities:
* Managing customer interactions in an efficient, empathetic, and timely manner to deliver high standards of customer satisfaction.
* Effectively managing all types of claims.
* Reviewing claims accurately in accordance with Company guidelines and best practices.
* Reviewing allocated cases and achieving settlement within designated personal authority level and in line with established standards, procedures, and guidance provided.
* Identifying non-standard or complex claims and escalating them to more senior colleagues to ensure they are handled appropriately.
* Ensuring that Company service standards are upheld, adhering to company policies and regulatory requirements when facilitating claims processing.
* Evaluating insurance policy coverage for claims advised.
* Ensuring system reads all data accurately for each claim, making amendments where necessary.
* Responding in a timely manner to internal and external inquiries for information relative to claims.
* Reviewing, preparing, creating, and/or sending letters, reports, and forms as required for any claims.
* Communicating claim action/processing with the claimant in a clear and empathetic manner.
* Identifying notification issues, coordinating resolution, and taking corrective actions as needed.
* Completing ongoing CPD to maintain relevant qualifications.
Required Skills & Qualifications:
* Proven experience in a Life Assurance Company, preferably in a Claims or Underwriting environment.
* Diploma in Life and Disability Claims (DLDC) or the CII Diploma in Life and Disability Underwriting (DLDU) or QFA Qualification or Accredited Product Advisor (Life Assurance & Pensions).
* Possess and demonstrate a level of general technical knowledge and other skills sufficient to handle assigned caseload of claims within designated handling authority.
* Ability to read and interpret medical reports.
* Exhibit strong critical thinking and problem-solving skills.
* Demonstrate careful attention to detail, diligent and conscientious in the accuracy of their work.
* Excellent written and verbal communication skills.
#J-18808-Ljbffr