Experienced Bodily Injury Claims Specialist
Location: Wexford Type: Permanant Category: Customer Service, Office Support / Admin Salary:
40,000 to 50,000
Our client is one of Ireland's leading general insurance companies offering a wide range of insurance products. They are currently recruiting a third-party administrator to join their Claims Team in their site in Rosslare in Wexford or Blackrock Dublin.
The fitting candidate will be responsible for overseeing and monitoring the delivery of a robust and effective control environment related to the provision of claims services provided by TPA to ensure the service provided meets the needs of its customers.
The scope of the role includes the oversight of a portfolio of motor damage and bodily injury claims handled under delegated authority by a TPA. You will also be responsible for assisting in the oversight of services provided by our property loss adjusting panel.
This is an exciting opportunity for a career-focused individual to gain experience in a varied and fast-paced role.
What does my day-to-day look like in this position?
1. Implement and manage procedures, controls, and escalation processes to ensure the timeliness and accuracy of the TPA’s handling of motor damage and bodily injury claims under delegated authority.
2. Responsible for completing due diligence, technical guidance, and contract development on new and existing TPA’s.
3. Oversee claims which are outside the scope of the TPA’s claims handling authority and provide direction on setting of reserves, policy coverage, investigation strategies and settlement of claims.
4. Monitor claim reserves and where required prepare files for referral to the reserve Committee.
5. Monitor TNPS scores on all claims and provide the necessary feedback to stakeholders.
6. Manage & coordinate complaints made by customers. Ensure all complaints are investigated and resolved in line with the Complaints Policy.
7. Assist in the scheduling, organisation and conducting of TPA and loss adjuster claim file audits to ensure compliance with regulatory, legislative, contractual and the Global Claims Policy (GCP) requirements.
8. Participate in wider departmental claim file audits or legal panel audits, as required.
9. Proactively work towards a system of continuous improvement around processes and procedures.
10. Adheres to the agreed Global Claims Vendor & TPA Management Best Practises.
11. Manage the implementation of projects, either as a small discrete initiative or a defined part of a business change program to deliver defined objectives
What experience is required for this position?
12. A minimum of 5 years relevant claims handling experience managing a portfolio of bodily injury claims.
13. At least 3 years’ experience handling household and commercial property claims would be preferred.
14. CIP qualification required and ACII qualification desirable.
15. Must be accredited under the Minimum Competency Requirements.
16. Demonstrate an advanced standard of technical claims competence for handling moderate to high complexity bodily injury claims up to High Court level.
17. Demonstrate an intermediate standard of technical claims competence for handling household and commercial property claims.
18. Possess strong policy language skills enabling accurate and consistent policy wording interpretation for coverage oversight
19. Knowledge and/or experience managing TPA’s and / or property loss adjusters a distinct advantage.
20. Experience in Managing Large Self-Insured Risks.
21. Extensive experience in negotiation, particularly via attendance at Court.
22. A strong understanding of Governance & Oversight standards & requirements.
23. Ability to recognize, understand and adhere to appropriate legislative regulations.
24. Strong communication skills, both written and verbal and ability to demonstrate this effectively in relation to Managing external partners.
25. Strong decision making and sound numeric skills.
26. Desire to learn and be flexible to business change.
27. To foster a culture of continuous improvement so that they are recognised externally as being the best-in-class claims provider in the market.
28. Be solution oriented and able to demonstrate instances where they have been innovative in problem solving.
If you may be interested to hear more about this position and to discuss your suitability to please reach out to Lorna in confidence on 015225354 or email your CV to lorna.andreucetti@RECRUITERS.ie Your CV will not be sent to any third party without your consent .
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