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Clinical Claims Assessor
2 months ago
We are seeking a highly skilled Clinical Claims Assessor to join our team at Canada Life Group (UK) Ltd (The). As a key member of our claims team, you will be responsible for assessing and validating clinical claims associated with our individual and corporate insurance products.
Key Responsibilities- Claims Assessment and Validation
You will independently set up claims to accurately reflect the financial liability, ensuring that only valid claims are paid in accordance with the policy terms and conditions.
Eligibility CheckingYou will analyze and appraise all information received, requesting gaps in medical and non-medical information from appropriate sources, and ensuring that only those with a financial liability exist progress to full claim assessment.
Claim Validity and RecoveryYou will conduct regular reviews of evidence to appraise claim validity and secure safe returns to work, ensuring that benefits are only paid for the period the claim is valid.
Customer Service and CommunicationYou will demonstrate an engaging and outstanding level of customer service, ensuring that strategic distribution partners and corporate clients remain with Canada Life for the long term.
Compliance and Risk ManagementYou will ensure that all claim activity corresponds with Risk, Compliance, and Legal guidelines, and maintain thorough audit trails to reflect the highest levels of integrity required in a claims environment.
Requirements- Insurance Industry Knowledge
You will have some broader knowledge of insurance/protection products, group, and/or the health claims industry.
Claims Assessment and ValidationYou will be highly capable in following company procedure and applying policy terms correctly.
Customer Service and CommunicationYou will demonstrate outstanding customer service skills to help maintain strong individual and corporate protection business sales.
Regulatory, Risk, Conduct, and ComplianceYou will be highly attuned to the Risk Culture and have high levels of awareness regarding handling personal sensitive information in a claim environment.
Company Strategy and Core ValuesYou will share knowledge with team colleagues and demonstrate willingness to support broader business and strategic goals.
What We OfferWe believe in recognizing and rewarding our people, offering a competitive salary and benefits package, including a generous pension and bonus scheme, income protection, private medical insurance, and life assurance. We also offer a range of training, flexible working, and opportunities to grow and develop.
We are committed to building an inclusive workplace with a diverse workforce where everyone can feel they belong and achieve their potential, regardless of gender, ethnicity, or any other characteristic.
