Trainee Claims Assessor

at  UTMOST WEALTH SOLUTIONS

KEY REQUIREMENTS

Knowledge – Experience or qualifications

• Previous experience in an office-based environment.
• Business Related Degree essential.

Skills

• Comfortable using Excel and Word.
• Strong organisational skills.
• Solid communication and relationship management skills.

Behaviours

• Ability to work toward tight deadline within a fast-paced environment.
• Open to continuous development regarding industry educational qualifications – DLDC Diploma (III) or QFA (LIA).

KEY RESPONSIBILITIES

Customer Relationships

• To maintain effective broker relations, providing customers with prompt, accurate and comprehensive replies.
• Deliver high quality customer communications.
• Initiate day-to-day communication by telephone/email with Irish and International brokers, clients, members, claimants and medical professionals.
• Develop and maintain strong relationships with internal departments including Sales, Pricing, Finance, Claims, Underwriting, Compliance, Risk and Marketing;
• Active participation in team meetings, one to ones, client/ broker meetings.

Maintain key relationships (Internal & External)

• Builds and maintains effective working relationships with Utmost colleagues in multiple Jurisdictions, Morgan Ash, Advance Medical and all external service providers to cover claim management operational issues.
• Ensure adherence to all operational procedures to in the multi-jurisdictional offices.
• To ensure communications between operational staff and related Utmost offices is working effectively and without duplication of effort.
• Actively participate in the Claims team weekly meeting.

Customer Service

• Ensure all internal and external service levels are adhered to.

Claims Administration & Management

• Deliver optimum efficiency and high quality administration service at all times.
• Resolve client queries in a prompt & sensitive manner.
• Adhere to Reinsurer guidelines and Treaty rules.
• Be resilient in facing day-to-day work challenges and focused on achieving desired results. Maintain Claim database and Post Logs.
• Adherence to all procedures and Operational Risk
• Request medical information or arrange medical examinations as required
• Approve & pay invoices on a weekly basis.
• Provide relevant weekly and monthly information to Finance Dept.
• Run weekly payroll reports for claims expenses incurred in a timely manner.
• Continuously monitor Independent Consultants quality, fees, report turnarounds and performance.
• Provide feedback to Head of Claims and Technical Claims Manager on positive and negative quality identified.

Quality Control

• Adhere to process controls on all aspects of claims administration to ensure high standards are set and maintained.
• Streamline the delivery of administration function to obtain maximum efficiency.
• Ensure 100% accuracy on data input for delivery of benefit payrolls for UCS Claims Dept.
• Identify trends and propose solutions to increase accuracy and strengthen controls.
• Instil 100% accuracy philosophy on all aspects of claims administration.
• Comply with all Fiscal, legal and regulatory obligations e.g. GDPR, CPC