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Claims Management Specialist
2 months ago
We are seeking a highly skilled Claims Management Specialist to join our team at Canada Life Group (UK) Ltd (The). As a Claims Management Specialist, you will play a critical role in ensuring the accuracy and validity of health claims associated with individual and corporate insurance products.
Key Responsibilities- Independently set up claims to accurately reflect the financial liability, within authority levels.
- Ensure escalation controls and checking procedures are followed for high benefit claims that exceed financial retention limits or personal authority levels.
- Analyse and appraise information received, including complex, multi-layered claims with objective and subjective, medical and non-medical information.
- Communicate complex health claim decisions, including those with mixed medical evidence, with empathy and in plain English to ensure claimants understand reasons for claim outcome.
- Conduct regular reviews of evidence to appraise claim validity and secure safe returns to work, ensuring benefits are only paid for the period the claim is valid.
- Research and investigate prolonged absence, beyond expected recovery timescales, to identify causes and implement appropriate actions plans.
- Demonstrate an engaging and outstanding level of customer service to ensure strategic distribution partners and corporate clients remain with Canada Life for the long term.
- Recognise claimant vulnerabilities and ensure customer service skills reflect a considered course of action.
- Ensure all claim activity corresponds with Risk, Compliance, and Legal guidelines and thorough audit trails reflect the highest levels of integrity required in a claims environment.
- Knowledge of insurance/protection products, group, and/or the health claims industry.
- High degree of medical knowledge to establish validity of complex claims with mixed evidence of validity.
- Ability to challenge information with skill, care, and appropriate conduct to ensure only valid claims are paid.
- Highly capable in following company procedure and applying policy terms correctly.
- Strong attention to detail to ensure fair and correct outcomes for every claim.
- Demonstrates outstanding Customer Service skills to manage complex claim scenarios.
- Uses all resources available to seek out the swiftest route to accurately verifying claims.
- Strives to improve processes for the benefit of customers, claimants, and Canada Life.
We believe in recognising and rewarding our people, so we offer a competitive salary and benefits package that's regularly reviewed. As a Canada Life UK colleague, you'll receive a competitive salary and comprehensive reward package, including a generous pension and bonus scheme, along with income protection, private medical insurance, and life assurance.
We invest in the development of our people, technology, and workplaces, offering a range of training, flexible working, and opportunities to grow and develop. We're 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.