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Technical Income Protection Claims Specialist
20 Apr 2023
Technical Income Protection Claims Specialist
About the Position
Reporting to the Head of Claims/Senior Technical Claims Manager, this role requires expert case management delivery of technical claim decisions and training of Junior Claims Assessors and Claims Administrators in the Employee Benefit Claims team across a sophisticated and diverse PanEurope corporate client base.
To manage a portfolio of claims by ensuring best practise approach is adopted as possible in order to meet competency levels and qualifications required to work in a busy claims function under MCC guidelines.
The role holder will medically assess all Group Risk product claims, typically - life, critical illness and income protection/ disability claims on Irish and international schemes/policies as they occur and at claim review stage, making recommendations and decisions within agreed limits.
The role holder will have a primary coordinating role with Group companies, GEB, Reinsurers, Chief Medical Officer, IME consultants, Investigation services companies, Marsh, CUNA and also with the Customer Relationships & Complaint Resolution
Customer Relationships & Complaint Resolution
To maintain effective broker relations, providing prompt, accurate and comprehensive replies to customers, dealing personally with complex issues and the effective resolution of any complaints.
Maintain key relationships (Internal & External)
Builds and maintains effective working relationships with Head of Business lines, Heads of Support Functions, the senior staff in company offices in multi Jurisdictions, Marsh, MorganAsh, CUNA and all external service providers to cover claim management operational issues.
Act as the key technical contact for Employee Benefit claims team in relation to escalations, queries, complaints and reporting.
Establish a service culture within the Employee Benefits Function so that the operation meets or exceeds agreed KPI’s, SLA,s and other service standards
Collate feedback from brokers and clients against agreed standards and report to Head of Claims and/or Technical Claims Manager in order to continuously enhance our service proposition.
Claims Administration & Management
Deliver optimum efficiency and high-quality claims service.
Continuously aim to improve decision turnaround on pre-assessment claims.
Ensure high quality claim decisions are made in a sensitive manner.
Ensure an individual case management approach is adopted for all claims.
Show rigid flexibility on all claims and client issues.
Adhere to Reinsurer guidelines and Treaty rules.
Ensure all claims are managed in line with our local & personal Claim Approval Limits (CALs).
Liaise with colleagues, employers, third parties, CMO, physicians and rehab providers to ensure claimants successful and sustained reintegration to the workforce.
Ensure all complex claims are managed appropriately and in conjunction with the Head of Claims and Senior Technical Claims Manager.
Provide continuous feedback to Head of Claims and Senior Technical Claims Manager of any areas identified regarding policy terms and conditions on all products to ensure relevant and applicable to current markets.
Ensure Claims Process Document is regularly reviewed and updated with any process changes.
Aim for parity on claim decisions –V- claims received in any given reporting period.
Possess a high level of technical and medical expertise.
Be resilient in facing day-to-day work challenges and focused on achieving desired results.
Identify, consider and offer rehabilitation opportunities for claimants.
Claims Assessor & Administrator Training and Development
Actively engage with Head of Claims and Senior Technical Claims Manager on technical training requirements and delivery for junior team members.
Continuous technical development of junior team members.
Optimise personal and colleagues performance.
Enable staff deliver UCS Claims Philosophy effectively.
Support, enable and coach team members in order to reach full potential.
Ensure appropriate development plans are in place.Up-skill and improve technical knowledge of junior assessors and administrators
Adhere to process controls on all aspects of claims management to ensure high standards are set and maintained.
Third level education with a professional qualification in Claims Management industry related.
Diploma in Life and Disability (DLDC) under the III.
Grandfathered Status under MCC.
QFA in Life, Pensions & Regulations under LIA.
Minimum of 5 years’ medical IP claims assessment.
Expert knowledge of Group Risk Products. Streamline the delivery of services to obtain maximum efficiency.
Salary up to €75,000 plus full benefits
For more information on this position or other
on 01-5927886 or hit the apply button below to send your cv. Alternatively, contact her directly via
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