Senior Claims Assessor

Sanderson; West of England; On-site; GBP 32,000 - 42,000; Full time

Benefits offered by this job

31 days holiday including Bank Holiday

Annual discretionary bonus scheme

Cycle to Work Scheme

Wellbeing programme

Moments that Matter policies

Pension with 6% match

Life Assurance

Job summary

Diligenta invites applications for a Senior Claims Assessor in the claims department, with roles in Bristol, Salisbury or Peterborough. You will be responsible for admittance decisions, proactive claims management, and detailed investigations to assess income protection, waiver of premium, critical illness, and other major claims.

Role requires strong communication with claimants, coaching of junior assessors, and adherence to service standards.

Qualifications

• Experience in one or more claims areas: Income Protection, Waiver of Premium, Critical Illness, Permanent Total Disability or Death claims.

Responsibilities

• Make admittance decisions and recommendations within admittance authority for declines, terminations or mis-representation.
• Proactively manage a portfolio of claims and liaise with claimants throughout the process.
• Gather and assess medical and other evidence to reach timely, fair decisions.
• Support development of the company’s claim philosophy and protocols.
• Provide technical guidance to Risk Claims teams and ensure compliance with standards.
• Meet service levels and audit targets; participate in projects to improve claims management.

Skills

Income Protection

Waiver of Premium

Critical Illness

Permanent Total Disability

Death Claims

Microsoft Office

Job description

Diligenta's vision is to be acknowledged as 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 that is founded on positive change and development.

Summary of the role

We currently have a vacancy for a Senior Claims Assessor in the claims department in Bristol, Salisbury or Peterborugh. This role involves making fair, correct, efficient decisions whilst hitting our targets as well as effectively assessing claims in at least one or more of the following areas, depending on the business need: Income Protection & Waiver of Premium, Critical Illness, Permanent Total Disability and Death claims.

What you’ll be doing

• Making admittance and medical decisions and make recommendations within admittance authority for declines / terminations / mis-representation.
• Proactively manage a nominated portfolio of claims.
• Liaising with claimant(s) throughout the claims process and thoroughly investigate all claims, requesting and using appropriate medical and other evidence to assess the claim proactively within the agreed service standards
• Making recommendations to develop innovatively the Company’s claim philosophy and protocols.
• Providing authoritative technical support to the Risk Claims administration teams.
• Meeting service delivery measures of agreed service levels and elapse times.
• Undertaking projects, sponsored by the Risk Claims Manager, to develop the effectiveness of the Company’s claims management and improve its standing in the eyes of key stakeholders
• Carrying out technical audits and review technical competencies, providing feedback and coaching to ensure claims are managed in accordance with the Company’s claims philosophy and protocols and that claims assessors are maintaining appropriate levels of technical competence and safeguarding the company’s relationship with Aviva and our reinsurers.
• Meeting Technical and Quality Audit targets.

What we’re looking for

• Previous experience in at least one of Income Protection, Waiver of Premium, Critical Illness, Permanent and Total Disability and Death Claims assessment
• Excellent telephone manner with the ability to deal with anxious distressed and sometimes angry customers
• Strong Microsoft and general PC skills.
• Proven ability to make admittance, declinature and medical decisions and make recommendations within admittance authority.
• Proven ability to coach and mentor less experienced claims assessors to enable them to develop their technical knowledge.
• Flexibility and adaptability
• Planning and organisational skills
• Excellent letter writing skills, the ability to draft detailed non-standard letters.
• A good level of general education in appropriate subjects is preferred.
• 31 days including Bank Holidays
• Eligibility for an annual discretionary bonus scheme
• Personal and career development opportunities to progress your aspirations within the company as well as through our global parent company (Tata Consultancy Services)
• Access to Perks at Work (an online discounted shopping platform) saving you money on a wide range of goods and services, including your weekly food shop, holidays and electrical goods
• Cycle to Work Scheme & Interest free Season Ticket loans
• A companywide Wellbeing programme, including an Employee Assistance Programme and other benefits/resources to support your mental/physical and financial wellbeing
• A comprehensive set of Moments that Matter policies, such as Carer’s Leave, Foster Leave and Retirement Leave
• A contributory company pension scheme where we match your contributions up to 6%, Group Life Assurance ('Death in Service") & Group Income Protection

If you need any help or adjustments for any stage within the recruitment process due to health, disability, or any other reason, please let us know.