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Telford, Telford and Wrekin, United Kingdom Diligenta Full timeAbout the RoleDiligenta is a life and pensions administration service provider seeking a Claims Assessor to join their operations function.Key ResponsibilitiesExamine and evaluate insurance claims for accuracy, completeness, and eligibility based on policy terms and conditions.Make informed decisions regarding the approval or denial of claims based on...
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Telford, Telford and Wrekin, United Kingdom Diligenta Full timeJob SummaryDiligenta is seeking a skilled Health Claims Assessor to join our operations function. As a key member of our team, you will play a crucial role in managing individual protection claims from initial notification through to final settlement.Key ResponsibilitiesExamine and evaluate insurance claims for accuracy, completeness, and eligibility based...
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Health Claims Examiner
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Telford, Telford and Wrekin, United Kingdom Diligenta Full timeAbout the RoleDiligenta is seeking a skilled Health Claims Assessor to join our operations function. As a key member of our team, you will play a crucial role in managing individual protection claims from initial notification through to final settlement.Key ResponsibilitiesExamine and evaluate insurance claims for accuracy, completeness, and eligibility...
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Health Claims Examiner
2 months ago
We are seeking a skilled Claims Assessor to join our operations team at Diligenta. As a Claims Assessor, you will play a crucial role in managing individual protection claims from initial notification to final settlement, ensuring timely and accurate decision-making within agreed service standards.
Key Responsibilities- Examine and evaluate insurance claims for accuracy, completeness, and eligibility based on policy terms and conditions.
- Make informed decisions regarding the approval or denial of claims based on gathered evidence and policy guidelines.
- Investigate and verify the legitimacy of claims through document analysis, medical reports, and other relevant information.
- Liaise with medical professionals, legal advisors, and other third parties to obtain required documents and expert opinions.
- Maintain detailed and accurate records of all claim assessments, decisions, and communications.
- Ensure all claim files are up-to-date and comply with company policies and regulatory requirements.
- Offer exceptional customer service by addressing queries, concerns, and appeals from claimants promptly and professionally.
- Previous experience in claims assessment or a related field within the insurance industry.
- Experience in handling life insurance, health insurance, or pension claims is highly desirable.
- Strong analytical and critical thinking abilities to evaluate complex information and make sound decisions.
- Proficiency in analysing medical reports, financial documents, and other relevant data.
- High level of accuracy and thoroughness in reviewing claims and documentation.
- Ability to identify discrepancies and potential fraud.
- Excellent verbal and written communication skills for interacting with claimants, colleagues, and third parties.
- Ability to explain complex information clearly and concisely.
- Strong commitment to providing exceptional customer service.
- Empathy and patience in handling sensitive situations and distressed claimants.
Diligenta is a leading provider of life and pensions administration services. Our vision is to be acknowledged as the best-in-class platform-based life and pensions administration service provider. We strive to deliver exceptional customer service and transform our clients' operations.
