Claims Manager - Surrey - up to £35,000 plus benefits
Our client is actively seeking a professional individual to manage the medical UK claims operation in accordance with policy provisions, company and regulatory (including FSA) requirements. Ensure claims are processed promptly within agreed service level timelines, efficiently, under the terms and conditions and cost contained. To provide leadership and contribute to the overall functionality and infrastructure of the company. To ensure that service delivery is in alignment with the strategic principles, visions and values of the company and its Companies and Joint Ventures.
KEY RESPONSIBILITIES
Report to Group Claims Manager outstanding workloads on a weekly basis.
Contribute to monthly Global Claims operations meetings.
Oversee all weekly and monthly reports ensuring information is accurate and meets reporting deadlines.
Ensure all key strategies, business plan objectives and budgetary requirements are communicated and conveyed to staff as appropriate and that staff carry out their activity in accordance with the above requirements and their role responsibilities and key performance objectives.
Oversee and support the Claim Department to ensure all the processes, administration, technical queries and complaints are within service standards.
Direct responsibility for the employees, performance, workflow and customer service quality of the operations within your charge.
Monitor workflows in line with business projections and ensure effective staff resources and planning are in place to meet business demand.
Carry out weekly meetings with Claim Managers and ensure that minutes are recorded and action points followed up.
Carry out Claim Managers appraisals and development.
Carry out quality audits every quarter.
Audit TPA's linked to UK Operations as directed by Group Claims Manager.
Assist/deal with projects as directed by Group Claims Manager.
Assist other UK Claims Managers with any technical or contentious claims and complaints within the boundaries of medical knowledge and policy held.
Ensure correct referral lines are being carried out for claims over £10,000 and exceeding this.
Ensure we are liaising with our cost containment agents with a view to obtaining reductions to set charges with hospitals and other service providers.
Maintain up to date market awareness.
Ensure that all computer records are up-to date and accurate.
Ensure new starters are trained where required.
Manage and develop the internal relationships which allow the claims function to operate effectively and efficiently.
Develop and maintain beneficial working relationships with business partners, providers, brokers and agents.
Promote the best image for the company through the professional appearance and behaviour and adhere to company standards and procedures. To maintain the highest level of personal conduct.
EDUCATION & EXPERIENCE
Degree and/or equivalent work experience is required
2 years or more of claims management experience with responsibility for all areas of claims handling
Extensive knowledge of all areas of claims handling
Demonstrated strategic and critical thinking skills
Excellent written, verbal, and overall people management skills
Experience with claims technology and leading industry practices
PC Literate
PERSONAL CHARACTERISTICS
Excellent communication skills - verbal manner and written
Ability to explain concepts simply and unambiguous
