To adjust and process claims within a designated individual authority limit, undertake technical administrative tasks and assist in the oversight and management of 3rd party service providers supplying claims services to the Company. To provide prompt and efficient services to internal and external clients and to protect the Company's financial interests by ensuring the validity of claim payments and adequate reserving.Key accountabilities
Skills & experience
- Assisting the Accident & Health Claims Manager s in the management of both individual claims and claims handled by 3rd parties under delegated authorities across multiple business platforms.
- Routine maintenance of claims data via the in-house IT system(s) and that of 3rd party service providers for data input, reporting, data interrogation and report generation as required.
- Assessment of policy coverage and decision making on individual claims including dealing with telephone or correspondence queries from 3rd parties, brokers and customers or internal referral where appropriate.
- Working with market technology as required, adjust and authorise claim settlements and fees within a designated individual authority limit, escalating claims referrals as required.
- Monitoring, verification, reconciliation and reporting of both claims and performance Management Information from 3rd parties against set Service Level's
- Promoting the Company's Customer Conduct ethos consistently both internally and externally
- Development and maintenance of close working relationships with internal operational stakeholders including Delegated Authority, Compliance and Finance including data analytics and production of reports
- Assist with the preparation for and participation in auditing of 3rd parties as required.
- Manage technical administration such as 'static claims' and organise the provision of administrative services, maintain records and provide management information.
- Produce weekly claims handling statistics to the Claims Manager to enable effective monitoring of claims.
- Monitoring and maintenance of contractual relationships with 3rd parties
- A' Level/Degree and/or other relevant qualification(s)
- ACII qualified or working towards qualification
- Minimum 5 years related experience in Accident & Health classes
- Oversight and interaction with 3rd Parties preferred
- Understanding of specific claims knowledge around Accident & Health classes.
- Good written and verbal communication skills
- Good critical reasoning, numerical reasoning, problem solving, analytical and creative thinking skills
- Technical and presentation skills suitable for a professional environment
- Adaptability to change in a fluid commercial environment
- Self-motivated team player with good interpersonal skills and a willingness to use their own initiative within authorised parameters.
- Good IT skills, knowledge of Microsoft Office or similar packages e.g.: Database software
- Willingness to mix tasks and work in a changing environment, to achieve the efficient operation of the claims team