Clinical Claims Assessor
5 days ago
We are seeking a skilled Clinical Claims Assessor to join our team at Canada Life Limited. As a Clinical Claims Assessor, you will be responsible for assessing and validating clinical claims associated with individual and corporate insurance products. Your primary goal will be to ensure that only valid claims are paid in accordance with the financial liability associated with the insured risk.
Key Responsibilities- Independently set up claims to accurately reflect the financial liability, ensuring that escalation controls and checking procedures are followed for high-benefit claims that exceed financial retention limits or personal authority levels.
- Analyse and appraise all information received, requesting gaps in medical and non-medical information from appropriate sources. Ensure inconsistent information is clarified through effective research and questioning techniques.
- For clinical IP claims where recovery is expected, 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.
- For clinical IP claims where recovery is not expected (classified as X-files), check health and employment status in line with documented process and re-validate claims at appropriate times through to the policy cease date.
- 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. Handle medical records and Personal Sensitive information in line with the company procedure.
- Some broader knowledge of insurance/protection products, group, and/or the health claims industry.
- Highly capable in following company procedure and applying policy terms correctly.
- Strong attention to detail to ensure all relevant facts are obtained to ensure fair and correct outcomes for every claim.
- Demonstrates outstanding Customer Service skills to help maintain strong individual and corporate protection business sales.
- Uses all resources available to seek out the swiftest route to accurately verifying claims.
- Strong telephone and written skills that demonstrate the desire to go the extra mile to meet all customer and stakeholder requirements.
- Strives to improve processes for the benefit of customers, claimants, and Canada Life.
- Highly attuned to the Risk Culture.
- High levels of awareness with regard to handling Personal Sensitive information in a claim environment.
- Demonstrates professionalism through own behaviours and actions.
- Shares knowledge with team colleagues and demonstrates willingness to support broader business and strategic goals.
- Flexibility evident to support other teams depending on service standards and volumes of incoming work by team.
- Willing to cross-skill to ensure consistent service standards can be maintained across the business function.
- Responds positively to change through constructive commentary.
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 have a fantastic number of other benefits and support services as well as regular personal and professional development.
How We WorkOur culture is unique and incredibly important to us. We care about doing the right thing for our people, customers, and community and helping others to build better futures. Our blueprint behaviours shape and influence how we work, and are central to the relationships we have with others. Every day we are encouraged to be more curious, own the outcome, face into things together, and find a way forward. We want colleagues to have rewarding careers with us so we invest in the development of our people, technology, and workplaces. That's why we offer a range of training, flexible working, and opportunities to grow and develop.
Diversity and InclusionBuilding 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 is a key commitment for us. We are proud of the progress we're making in DEI, and we continue for it to be a significant focus. We appreciate that everyone has different work and life responsibilities. We're happy to discuss flexible working arrangements, including part-time, for any of our roles should this be a requirement for you.
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Bristol, Bristol, United Kingdom Canada Life Group (UK) Ltd (The) Full time{"Job Title": "Clinical Claims Assessor", "Job Summary": "At Canada Life Group (UK) Ltd (The), we are seeking a skilled Clinical Claims Assessor to join our team. As a Clinical Claims Assessor, you will be responsible for assessing and validating clinical claims associated with individual and corporate insurance products.", "Key Responsibilities": " Set up...
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Bristol, Bristol, United Kingdom Canada Life Group (UK) Ltd (The) Full time{"Job Title": "Clinical Claims Assessor", "Job Summary": "At Canada Life Group (UK) Ltd (The), we are seeking a skilled Clinical Claims Assessor to join our team. As a Clinical Claims Assessor, you will be responsible for assessing and validating clinical claims associated with individual and corporate insurance products.", "Key Responsibilities": " Set up...
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