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Claims Assessor

4 months ago

Remote, United Kingdom Spinwell Full time

Role: Claims Assessor X 2 REF 2888
Contract Length: 6 months
Location: Remote
IR35: Inside
Pay Rate to Intermediary: £300-£380 per day
Security Clearance: Basic DBS

Spinwell is recruiting for a Claims Assessor for an excellent opportunity within the public sector.

**RESPONSIBILITIES OF THE CLAIMS ASSESSOR**
- To pro-actively assess and manage Disability claims that may include Waiver of Premium, Income Protection, Critical Illness and Life
- Time Care benefit (and other product benefits that are specific to a client account).
- To deliver an accurate, efficient and quality service in line with the CLPS service level agreements and receive excellent feedback following internal and external claim audits.
- To interpret policy terms and conditions, medical evidence and financial accounts in order to reach a decision on the validity of a claim.
- Provide thorough and robust justifications for decisions and refer cases to third parties including, CMO, reassurers and client company contacts in an accurate and clear manner.
- To communicate well both verbally and in writing to give clear instruction, adhere to TCF, manage the claimant’s expectations and portray client’s high standards of claim assessment.
- To support our pro-active approach to claim management by use of the telephone wherever appropriate to establish the circumstances of a claim, clarify information, triage and manage the expectations of the claimant.
- Share knowledge and experience in the delivery of training and guidance to others.
- To be fully competent and experienced in handling complaints and appeals and/or analysis (if applicable to the client

**SKILLS/EXPERIENCE OF THE CLAIMS ASSESSOR**
- 5 GCSE’s including Maths and English.
- 3-5 years experience as a Claims Assessor.
- Experience with customer contact, desired but not necessary.
- Completion and competence in relevant training modules.
- Willingness to study for a Disability Claims Diploma, or similar, if deemed necessary.
- Ongoing commitment to self-development i.e. research of medical conditions.
- Will be expected to attend industry events and provide comprehensive and accurate feedback to the group following the event.
- Experience of Complaint and Appeal handling may be essential.

**KNOWLEDGE**:

- Good knowledge of products, services and systems.
- Expert knowledge of procedures and technical standards.
- Excellent knowledge of relevant legislation, FCA principles and, in particular, Treating Customers Fairly.
- A good market, risk and business awareness.
- Has a strong foundation medical knowledge.
- Has good knowledge of relevant client philosophies.

**SKILLS AND COMPETENCIES**
- Passionate about delivery of customer service and excellent claims management.
- Treat customers fairly.
- Demonstrates essential interpersonal skills i.e. listening to others, observing and questioning where appropriate.
- Ability to work in a team/team player, liaising with other Claim Assessors, Underwriters and Claim Administrators within the team and across client sites to gain advice to deliver an excellent claims management service.
- Cope with varying workloads and pressures.
- Excellent verbal and written communication skills with the ability to write non-standard letters of a complex nature.
- Excellent telephone skills which should include questioning skills, the ability to triage claims, identify ‘red flags’ discuss clearly and professionally the circumstances of a claim and manage the expectations of the claimant.
- Excellent judgement and decision making skills.
- Has a thorough and methodical approach, paying attention to detail in all aspects of claim assessment.
- Has excellent numeracy and literacy skills.

**Job Types**: Full-time, Temporary contract