Senior Claims Examiner - Healthcare

CNA Hardy; Greater London; On-site; GBP 45,000 - 60,000; Full time

Job summary

A leading specialist commercial insurance provider is seeking a talented claims handler to manage a diverse portfolio of complex claims. The ideal candidate will have significant claims handling experience and strong negotiation skills to develop effective resolution strategies. Responsibilities include evaluating claims, ensuring compliance with legal requirements, and mentoring junior staff. This position offers an exciting opportunity to make a significant impact within the insurance industry.

Qualifications

• Significant claims handling experience is mandatory.
• Ability to manage claims proactively in line with business goals.
• Thorough understanding of policy language and law.
• Strong analytical skills for viable solution development.

Responsibilities

• Manage a diverse portfolio of claims with limited supervision.
• Coordinate investigations and evaluations of claims.
• Develop strategies with stakeholders for resolution of complex claims.
• Ensure compliance with legal and regulatory requirements.

Skills

Claims handling experience

Analytical skills

Strong communication skills

Negotiation skills

Problem-solving skills

Job description

Under limited technical direction, investigates and effectively handles a broad range of claims. Works within specific limits of authority on assignments involving significant technical complexity and coordination. Utilising claims policies and guidelines, reviews coverages, determines quantum exposure, secures information and negotiates and settles/defends claims.

Key Responsibilities

• With limited supervision, manages a portfolio of claims, ranging in complexity
• Interprets more complex or unusual policy coverages, escalating issues as needed.
• Coordinates and performs investigations and evaluates claims through contact with insureds, brokers, business partners and experts. Seeks early resolution opportunities.
• Partners with solicitors, customers, brokers, experts and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims.
• Proactively manages claims, setting early and accurate reserves in line with reserving philosophy, and authorising payments within scope of authority.
• Through tight portfolio management, ensures large and significant claims are identified at an early stage and escalated appropriately, in line with internal reporting procedures.
• Provides guidance, assistance and mentoring to less experienced claims staff and other function areas.
• Utilises negotiation skills to develop complex settlement packages.
• Responsible for input and maintenance of claim data that accurately reflects claim financials, circumstances and other information important to our business outcomes.
• Identifies claims with third party recovery/fraud potential and coordinates with relevant Stakeholder functions.
• Analyses claims activities. Prepares and presents reports for management. May be responsible for special projects and presentations.
• Keeps current on relevant legislation, regulation and issues as well as industry activity and trends.
• Complies with all applicable legal and regulatory requirements and ensures, at a level appropriate to the position, that appropriate measures are in place to ensure this compliance.
• May perform additional duties as assigned.

Skills, Knowledge & Experience

• Significant proven claims handling experience.
• Ability to handle claims with a proactive long-term view of business goals and objectives.
• Thorough understanding of policy language and application of the law relevant to specific class(es) of business.
• Strong analytical and problem solving skills enabling viable alternate solutions.
• Ability to assess the merits of claims including evaluation based on a cost benefit analysis.
• Understanding of underwriting risk, disciplines and processes.
• Strong interpersonal, communication and negotiation skills.Ability to effectively interact at all levels with CNA Hardy's internal and external business partners.
• Ability to adapt to change and value diverse opinions and ideas.
• Appropriate knowledge of all relevant regulatory and legal requirements applicable to the position.
• Previous experience of ECF preferred.

The Company

CNA Hardy is a leading specialist commercial insurance provider for clients within the Lloyd’s and company markets. We offer a highly specialised and comprehensive portfolio of innovative and market leading products. Coverage is available to businesses of all sizes for domestic, international and global exposures.