Operations Executive: Claims & Subscriptions Lead

Crédit Agricole Group; Dublin; On-site; EUR 60,000 - 75,000; Full time

Job summary

Crédit Agricole Group is seeking a detail-oriented professional in Dublin to efficiently investigate and process claims, administer medical subscriptions validation, and provide business support across Operations. You will ensure quality, deliver timely decisions, and contribute to continuous process improvements while coordinating with TPAs and underwriters.

The role emphasizes adherence to policy terms, strong customer service, and maintaining high internal quality metrics in a collaborative

Responsibilities

• Assess and process claims within the PPI portfolio according to relevant policy terms and conditions
• Process and decision claims over the delegation for all businesses based on recommendation received from TPA and according to the relevant policy terms and conditions. Confirm approval to TPA
• Provide customer service for inbound and outbound calls
• Check monthly reporting per partner for its accuracy and completeness
• Check Claims transfer request forms and sign off monthly/weekly confirming accuracy
• Propose process improvements to the processing investigation and settlement of claims
• Report on productivity to Team Leader/Manager
• Provide business support where required in Operations area
• Maintain an individual internal quality level > 95% on a monthly basis
• To administer subscriptions input and validation following recommendation from medical underwriters
• To ensure proper communication between the team staff in the Dublin office, the local TPAs, and medical underwriters to ensure timely decisions are communicated to the partners following service standards
• To assist in the management and reporting of Complaints when complaints analyst is out of the office or if needed
• To ensure and follow the complaints procedure associated
• Assist in creating and updating claims, subscriptions procedures as and when necessary, for new and existing business
• Assist the Team Leader in ensuring that all business documentation for the department is up to date, filed and archived
• Present suggestions for reviewing and updating procedures to Team Leader and implement, coordinate, and monitor any upgrades to procedures as they are signed off
• Provide training both internal & external
• Maintain various regular and ad hoc reports and provide to your Team Leader
• Perform other work or projects as and when selected by the Team Leader or Operations Manager

Job description

Crédit Agricole Group is seeking a detail-oriented professional in Dublin to efficiently investigate and process claims, administer medical subscriptions validation, and provide business support across Operations. You will ensure quality, deliver timely decisions, and contribute to continuous process improvements while coordinating with TPAs and underwriters.

The role emphasizes adherence to policy terms, strong customer service, and maintaining high internal quality metrics in a collaborative