Health Claims Assessor

TN United Kingdom; Telford; On-site; GBP 25,000 - 45,000; Full time

Job summary

Join a forward-thinking company as a Claims Assessor, where you will manage individual protection claims from notification to settlement. This role is crucial in ensuring adherence to service standards and policies while providing excellent customer service. The organization is committed to positive change and development, offering a supportive environment where your contributions will make a difference. If you're looking for personal and career development opportunities within a global parent company, this is the perfect chance to advance your career in a dynamic team.

Benefits

33 days holiday including Bank Holidays

Annual discretionary bonus scheme

Personal and career development opportunities

Access to Perks at Work

Cycle to Work Scheme

Interest-free Season Ticket loans

Wellbeing programmes

Contributory pension scheme with up to 6% matching

Group Life Assurance

Income Protection

Qualifications

• Experience in claims assessment or related fields within insurance.
• Strong analytical and decision-making skills.

Responsibilities

• Examine and evaluate insurance claims for accuracy and eligibility.
• Make informed decisions regarding claim approval or denial.
• Provide exceptional customer service by addressing queries promptly.

Skills

Claims Assessment

Analytical Skills

Customer Service

Communication Skills

Attention to Detail

Job description

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Our vision is to be acknowledged as a Best-in-class Platform-based Life and Pensions Administration Service provider. Customer service is at the heart of everything we do, and our aim is to transform our clients' operations. A business that has been described as 'home' by existing employees, we drive a culture founded on positive change and development.

Summary of the role

We have an exciting opportunity for a Claims Assessor to join the operations team at Diligenta.

You will play a key role in managing individual protection claims from initial notification to final settlement, ensuring adherence to service standards and your level of authority.

Your responsibilities include managing and assessing all claims in line with our claims philosophy and policy terms and conditions.

Benefits include:

• 33 days including Bank Holidays
• Eligibility for an annual discretionary bonus scheme
• Personal and career development opportunities within the company and our global parent, Tata Consultancy Services
• Access to Perks at Work, offering discounts on various goods and services
• Cycle to Work Scheme & Interest-free Season Ticket loans
• Wellbeing programmes, Employee Assistance Programme, and other support resources
• Moments that Matter policies, such as Carer's Leave, Foster Leave, and Retirement Leave
• Contributory pension scheme with up to 6% matching, Group Life Assurance, and Income Protection

What you'll be doing

• Examine and evaluate insurance claims for accuracy, completeness, and eligibility based on policy terms and conditions.
• Make informed decisions regarding claim approval or denial based on evidence and policy guidelines.
• Investigate and verify the legitimacy of claims through document analysis and relevant information.
• Collaborate with medical professionals, legal advisors, and third parties to obtain necessary documents and opinions.
• Maintain detailed records of assessments, decisions, and communications.
• Ensure claim files comply with company policies and regulatory requirements.
• Provide exceptional customer service by addressing queries, concerns, and appeals promptly and professionally.
• Explain claim decisions and policy coverage clearly to claimants.

What we're looking for

• Experience in claims assessment or related fields within insurance.
• Experience with life, health, or pension claims is highly desirable.
• Strong analytical and decision-making skills.
• Proficiency in analyzing medical reports and financial documents.
• High accuracy and thoroughness in reviews.
• Ability to identify discrepancies and potential fraud.
• Excellent communication skills for interacting with claimants and stakeholders.
• Ability to explain complex information clearly.
• Commitment to customer service excellence.
• Empathy and patience in handling sensitive situations.

If you require any adjustments during the recruitment process due to health, disability, or other reasons, please inform us.

Ready to advance your career? Apply today and join our innovative team!