Description:
Accountability and Main responsibilities of job:
- Operate within own area of accountability, escalating issues and seeking guidance when required
- Investigate, evaluate and decision make
- Progress own caseload to avoid litigation, reduce costs and achieve a fair and speedy settlement
- Undertake Third Party Rights investigations and ensure the provision of appropriate advice/guidance to the teams
- Follow ‘Best Practice’, utilising documentation and procedures
- Attend meetings with the client, along with policy colleagues to provide technical input where required
- Follow protocols and guidelines to ensure client’s service standards are met in accordance with Service level agreements
- Adhere to Capita Insurance Services policies and procedures In particular to ensure operational controls are carried out in accordance with laid down procedures, to ensure the ongoing mitigation of business risk (In this regard regular training should be agreed with the Service Delivery Director /Team Manager)
- Liaise in a professional manner with external and internal customers using the most appropriate medium, e.g. telephone, e-mail, letters, etc
- Build and maintain effective relationships with all customers
- Adhere to defined quality standards and quantitative targets whilst managing and prioritising own workflow
- Contribute to the achievement of both financial and reputational targets
- Commit to own personal development, maintaining and developing technical knowledge and expertise
- Ensure compliance of regulatory requirements
- Ensure effective use of internal technology
- Provide support, mentoring and guidance as required
- Work in accordance with your own personal authority as indicated in the Authority Matrix.
- Reviewing and analysing claims for accuracy, completeness and eligibility.
- Delivering an accurate, efficient high-quality service in line with service level agreements
- Reviewing all claims to assure adherence to and compliance with the approved business processes and responsibilities of all parties involved in evaluating, processing and handling each claim.
- Offering professional and empathetic communication to all claimants throughout the assessment journey.
Essential Job related experience, qualifications and skills:
- Proven history of EL / PL claims handling experience
- Recent disease claims handling experience
- Good understanding of medical and legal terminology
- Educated to GCSE grade 9 to 4 (A* to C) or equivalent including Maths and English
- Ability to build good working relationships
- Good communication skills at all levels
- Ability to achieve high standards of performance at all times.
- Good IT skills
- A commitment to learn and develop new skills
- Strong team player
- Ability to remain motivated in a changing working environment