Medical Claims Assessor

6 months ago

Hove, United Kingdom Legal & General Full time

Your role at a glance
Are you an experienced **Medical Claims Assessor **with **Income Protection **experience? Are you looking to join a team that supports your development and empowers you to make critical decisions regarding your clients?

We're looking for Individual Income Protection Assessors to join the team in Hove on either a hybrid or homebased basis.

The successful individuals will assess claims, by analysing medical information and corresponding with claimants, medical professionals and others as appropriate. You will use medical & financial knowledge to establish validity of claims, pay valid claims and decline invalid claims by providing a detailed explanation to ensure the protection of Legal & General’s reputation and profits.

What you'll be doing
- Gather appropriate evidence and assess information in order to accept or decline claims displaying logical reasoning. Consider the customers’ expectation of the product so that claims decisions are fair and Legal and General does not suffer unnecessary financial loss or reputational loss.
- Manage claims from end to end, processing within claims guidelines so that quality and consistency across the area can be maintained, adhering to service standards and processes.
- Liaise with internal and external customers and third parties in a professional, friendly and efficient manner in order to obtain information. Ensure that customers’ expectations of service are met whilst providing a positive impression of Legal and General. Utilise customer focused language
- Identify appeals and complaints and take ownership for trying to resolve them with urgency, so that complaints are acted upon quickly, root causes are escalated and customer satisfaction is achieved.
- Take responsibility for supporting colleagues with training, mentoring and development of other members of the claims team, to improve their skill level.
- Represent the claims team in claims projects or other team or department initiatives by sharing knowledge and ideas and giving feedback in order to promote continuous improvement.
- Take responsibility for managing claims of a contentious or sensitive nature, such as those involving fraud, litigation or prospect for litigation, liaising with Managers, GFC, and legal services so that the claim is effectively resolved.
- Ensure a consistent, timely and accurate level of service is maintained in line with service level agreements and promises made to meet customers’ expectations.
- Adhere to processes and systems to ensure that all customer data is dealt with appropriately in accordance with legislation, in particular GDPR, the Access to Medical Reports Act (1988) and Legal & General’s Confidentiality policy.

What we're looking for

Knowledge
- Claims processes
- Claims Philosophy
- Insurance products and policy conditions
- Awareness of Compliance regulations, and adherence to these
- Good medical knowledge
- Good understanding of financial calculations to support Claims Payment, including awareness of state benefits
- Comprehensive understanding of Underwriting, including New Business process
- Good understanding of Reinsurance process and treaties

Experience
- Ability to show empathy and sensitivity
- Good customer handling skills
- Good communication skills both written & verbal
- Ability to handle difficult calls, when researching circumstances which may lead to a claim being refuted

**Benefits**:
When you commit to Legal & General, we’ll commit to you too. That means we’ll recognise and reward your hard work, your performance and your contribution.

If you join us, you’ll get access to some great benefits, including private medical insurance, at least 25 days holiday (excluding bank holidays), a generous pension scheme, life assurance, and Income Protection. You can participate in our electric car scheme, which offers employees the option to hire a brand new electric car through tax efficient salary sacrifice. We’re also proud to offer competitive family leave.

You’ll have the opportunity to participate in our annual, performance-related bonus plan and valuable share schemes. And then there are the many discounts we offer that you can take advantage of - both for our own products and at a range of high street stores and online offerings.

About L&G
The brand with the brolly is choosing today to change tomorrow.

Since 1836, we’ve grown to become one of the world's largest asset managers, homebuilders, pension providers and insurance brands.

We’re all here to improve the lives of our customers, build a better society for the long term, and create value for our shareholders - helping to shape a better future for society and the planet.

We need people who share our ambitions, agility and entrepreneurial spirit to help us do it.

At L&G, you’ll find a balance that helps you be your best. Empowered by hybrid working, we’re supported by technology and workplaces that enable us to work effectively wherever we a

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