Medical Claims Officer jobs

We are on the hunt for a field based Claims Executive who will have responsibility for focusing on mid-market client claims for all client segments within their specified area of the business. You will also be responsible for managing the claims efficiently and effectively, however helping clients analysing claims data providing forecast and risk management oversight, interpreting trends, navigate complex loss, and strengthen the offering of our total commitment to each of our clients and colleagues, being client-centric and collaborative. Acting as the key conduit between clients and broking teams, TPAs and insurers ensure effective management of claims, where the role is highly client-facing.

These roles are required to cover the following geographical areas, where the majority of the role will be based- Scotland and NI North West, Central, and the South East of England.

Main responsibilities

• The primary focus of this role is to Focus on large client management in the mid market proposition for all client types, maintaining all the required standards of our claims service delivery by adhering to Group Procedures for claims as set out in both the Claims Operational Procedures Manual and Acturis Best Practice Guide
• Claims and incident analysis of client claims data for Claims defensibility, risk management assistance
• Reviewing and analysing similar industry trends to proactively focus clients with preventative measures
• To be proactive in the arrangement and management of regular client claim review meetings, and attend such meetings fully prepared and produce accurate up to date claims MI for the purpose of such meetings
• Support the Account Executive and broking teams, in person/virtually as required, at renewal meetings, new business/prospect meetings and when required, and be their technical referral point
• Produce Claims information and reports for client renewals and claims reviews, in good time and within specified deadlines
• Collaborate with colleagues in both broking and new business teams to ensure the provision of superior quality claims data, provision of our claims proposition to both existing clients and any prospective clients, driving for excellent client retention and supporting new business wins
• Ensure all claims details are recorded accurately and in accordance with procedural guides on the relevant PAS system
• Proactively deal with all claims, and promptly alert your line manager, conduct colleagues to any complaints, conflicts of interest, and Errors & Omissions (E&Os), in line with Group Policy and procedures reaching out to our Complex claims leader where appropriate

What are we looking for?

• Broad Technical knowledge of all general classes of insurance, with the ability to read, understand & interpret policy wordings and explain cover to clients & colleagues alike.
• Confident to challenge insurers on the interpretation of their own policies and apply it to claims, involving the Complex Claims leader for awareness should escalation be required.
• Able to present and host client face to face reviews, analyse claims data, spot trends and advise clients based on their claims performance, past, present & future.
• Strong interpersonal and communication skills across a scaled and multiple site Claims function
• Ability to manage expectations in a professional manner.
• Able to liaise with external and internal legal counsel to interpret their advice for our clients
• A robust understanding of business processes and performance levers
• Strong understanding of the internal and external Claims function, company performance, market intelligence, business drivers, etc
• Stakeholder management and strong communicator, including negotiation, contracting, consultancy, facilitation, influencing, presentation and communication skills

So, what are you waiting for? Apply today and one of our team will be in touch

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Everywhen is an equal opportunities employer, with a growing and thriving diversity, equity and inclusion strategy; we are committed to a working environment that is free from discrimination, is inclusive, and empowers our people to bring their whole self to work and reach their full potential.

If your application is successful, we will conduct relevant employment checks prior to you commencing employment with us. These will include verifying your recent employment, address, credit history and a standard criminal record check.

Please note: We may close a vacancy prior to the publish end date if the required quality or number of applications has been received.

Note to recruiters and employment agencies: We will not pay for unsolicited CVs from recruiters and employment agencies unless we have a signed agreement and have requested assistance, in writing, for a specific opening.

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