Technical Income Protection Claims Specialist

About the Position

Key Responsibilities

• 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.

• 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.

• 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.

• 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.

Experience/Requirements

• 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.

Remuneration Package

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