Claims Management Consultant

Claims Management Consultant focuses on ensure escalation controls and checking procedures are followed for high benefit claims that exceed financial retention limits or personal authority levels.

What the role involves

• Ensure escalation controls and checking procedures are followed for high benefit claims that exceed financial retention limits or personal authority levels.
• Follow company procedures to accurately check eligibility of claimants to ensure only those where a financial liability exists progress to full claim assessment.
• Analyse and appraise information received and request gaps in information from appropriate sources.
• Ensure inconsistent information is clarified through effective research and questioning techniques.
• Communicate complex health claim decisions, including those with mixed medical evidence with empathy and in plain English to ensure claimants understand reasons for claim outcome.
• Where prolonged absence is evident, beyond the expected recovery timescales, research and investigate to identify causes and implement appropriate actions plans.

Confirmed role details

• We’re happy to discuss flexible working arrangements, including Part Time, for any of our roles should this be a requirement for you.

Candidate fit

• Care and Knowledge of insurance/protection products. Group and/or the health claims industry.
• Care and appropriate conduct to ensure only valid claims are paid. This can mean challenging GPs or other medical professionals where inconsistent evidence has been provided.
• Demonstrates outstanding Customer Service skills to manage complex claim scenarios where disputes are more likely to arise than claims of a clinical type.

Additional role context

• Part of our parent company Great-West Lifeco, Canada Life UK has operated in the United Kingdom since 1903.