Senior Medical Claims Assessor

Leading Insurance Group have a permanent opportunity available for a Senior Medical Claims Assessor, this position has arisen due to growth in market share, the successful candidate will join the Underwriting and Claims team.

As a Senior Medical Claims Assessor, you will play a crucial role in the accurate and efficient assessment of Medical Claims made by customers. With your exceptional analytical skills and attention to detail, you will review claims documentation, assess eligibility, and make fair and informed decisions.

Key Responsibilities:

• Assess a variety of medical claims, including those related to Death, Serious Illness, and Income Protection, ensuring swift and sensitive resolution.
• Address inquiries from brokers, medical staff, and customers, providing expert guidance and support.
• Manage ombudsman inquiries and escalations with professionalism and efficiency.
• Utilise data analysis and management information to enhance claims assessment processes.
• Document and uphold the group's claims procedures with precision.
• Maintain accurate records within our claims database.
• Provide mentorship and training to junior team members, fostering their growth as claims assessors and administrators.
• Oversee a portfolio of income protection claims, ensuring thorough management and resolution.
• Conduct quality sampling and audits to uphold team standards.

Qualifications and Experience:

• Possession or pursuit of qualifications such as DLDU, QFA, or APA.
• Demonstrated experience in medical claims assessment, with a comprehensive understanding of medical terminology.
• Proficiency in assessing Income Protection products and associated claims.
• Familiarity with claims documentation systems and proficiency in providing management information/data packs.
• Expertise in effective communication strategies for gathering medical evidence.
• Proven track record of requesting and evaluating the minimum necessary medical evidence for informed decision-making.
• Commitment to maintaining customer satisfaction through clear and timely communication.
• Deep understanding of the philosophy behind claims management for customer benefit.
• Strong written and verbal communication skills.
• Experience in leadership and mentoring within a team environment.

For more information contact Elaine Liston in Sanderson on 0863516302 or apply online.