Medical Claims Assessor - Brighton

Brighton, East Sussex
£25,000 - £30,000 per annum
16 Nov 2016
14 Dec 2016
Contract Type
Full Time
Position: Medical Claims Assessor
Location: Brighton
Salary: £25000 - £30000 per annum
Job Type: Full time

Our company client is a fast growing life insurance business who are currently seeking to take on board a driven and articulate Medical Claims Assessor to join their highly skilled medical claims team based in Brighton, East Sussex. The successful candidate will be managing a caseload of medical, making an informative decision on liability to then either inform customer of outcome or take the claim to settlement. Please note that although the role is based in Brighton the insurer will consider home-working for 2 days per week.

Key deliverables for this role:

* Triage and assessment of group medical claims, determining what medical evidence to obtain in line with company philosophies.
* Provide a comprehensive assessment of medical claims, deciding whether to accept or reject liability and authorise payment as per individual authority limits as agreed
* Develop and build effective relationships with IFA's and Policyholders (employers), in order to maximise the effectiveness of our benefit management processes including the provision of support for the portfolio management of defined schemes.
* Authorise expenditure on appropriate external medical evidence to support the assessment of individual claims up to £5,000.
* Propose expenditure on rehabilitation or work re-integration programmes where there is a suitable cost/benefit justification for doing so.
* Where appropriate, assist in the provision of Management Data on portfolio accounts which analyses performance and identifies key trends.
* Train, mentor and develop other members of the benefits team, to improve their skill level
* Ensure a consistent, timely and accurate level of service is maintained in line with service level agreements and promises made to meet customers' expectations, and that are within scope of Customer Experience and Treating Customers Fairly policies. Where failures are identified, provide information and feedback to the relevant areas to enable changes and improvements to be made.
* Adhere to processes and systems to ensure that all customer data is dealt with appropriately in accordance with legislation, in particular the Data Protection Act (1995), the Access to Medical Reports Act (1988)

Experience and competencies required:

* 2+ years' experience of claims assessment, within medical or healthcare insurance
* CII prefered but not essential
* Excellent written and verbal communication skills
* Proficient in writing and handling business correspondence
* Ability to organise personal work priorities, with strong attention to detail
* Excellent organisational skills
* Strong customer service skills

Keywords: "claims" and "medical" and "insurance"

Please send an up-to-date copy of your CV to be considered for this position.