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Company Profile

Healthcare Insurance Claims Manager

Posted by i-Placements on 06.23.2015
Job ID: 714409
Location: Kingston Upon Thames, London, United Kingdom
Job Category: Insurance & Superannuation
Salary: £55,000.00 per year
Job Views: 12209
Post Code:
Employment Type: Full time
Posted: 06.23.2015


Banking: Agribusiness, Analyst, Asset Finance Sales, Back Office, Business Banking Sales, Cashier, Client Services, Compliance, Corp Actions/Divs, Corporate Business Sales, Credit/Risk Management, Derivatives, Director/Senior Management, Equity, Fixed Income, Front Office/Trading, Fund Administration, Fund Management, FX/MM, High Net Worth, Loans Administration, Offshore Banking, Private Banking, Project Management, Reconciliations, Retail Banking, Securities Lending/Collateral, Settlements, Static Data, Trade Finance, Trade Support, Trainee, Treasury/Payments, Other Banking
Other: Career Fair, Other, Work at Home

Job Description

Our Kingston based client is URGENTLY seeking to appoint an experienced Claims Manager to their team.

The successful applicant will have experience of working within the general insurance sector, preferably a private medical insurance environment, and will have a proven clinical background and knowledge. You will need to be Chartered Insurance Institute CII Certificate qualified.

The Claims Manager will be responsible for managing and leading a team within the Insurance Services Department to ensure the delivery of a professional, timely and accurate claims assessment, authorisation and handling service which provides consistent and fair outcomes to the Society’s members.

The Claims Manager will monitor, assess and report on team and individual staff performance against a range of agreed measures. They will also be expected to develop new and more qualitative focused measures which complement current reporting and help evidence how the department contributes towards the achievement of Society’s key strategic objectives and goals.

Key Elements

  • Maintain an excellent knowledge of insurance practices and hospital protocols and possess a sound clinical background and knowledge.
  • To be responsible for ensuring the delivery of high quality claims assessment, authorisation and handling service by the Claims Team, providing a high level of customer service at all times in a professional and helpful manner
  • To be pro-active in suggestions and ideas to improve member service and minimise claims costs to the business (within claims philosophy) and making a positive contribution to the department generally through high levels of technical knowledge, enthusiasm and workload.
  • To oversee the administration of Dual Insurance claims, ensuring that other insurer is contacted regularly for any contribution to the claim they may be able to make, and logging payments received from these insurers for statistical purposes.
  • To oversee the accurate and effective administration of overseas claims
  • To undertake case reviews and assessment alongside the Head of Insurance Services
  • To undertake regular audits of Claims Team case handling against internal controls and to monitor effective team and individual performance.
  • To maintain an excellent knowledge of policy terms and conditions, FCA requirements and FOS procedures and likely outcomes for the fair assessment of claims disputes
  • To assist with the annual policy review suggesting areas for improvement and/or review by the Head of Insurance Services and Senior Management Team
  • To contribute on strategic, development and project issues as required.
  • To ensure all incoming complaints, suggestions and compliments are dealt with effectively by the team and logged in accordance with procedural requirements.
  • To organise regular claims service questionnaire surveys, collate information and report findings and actions points in accordance with Treating Customers Fairly.
  • To work with the Head of Healthcare Services and other line managers in the Claims Department in consideration of issues for development of systems which are priority and result in a cost effective Claims Database for the department
  • To manage the creation and maintenance of Nova generated documents in line with policy terms & conditions, resulting in good customer service and high levels of member satisfaction
  • To collate regular information on service standards, including volume of post, invoices and telephone calls - reporting monthly on trends and whether service standards have been met

If you would like to receive a FULL and up to date job description please apply in the very first instance to this advertisement.

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