Full-Time Senior Claims Assessor (UK Remote)

Are you an experienced Claims Assessor? Are you looking for a remote-based role? We're recruiting for Senior Claims Assessors to join our expanding team.

Role Purpose: Provide excellent customer service and claims handling. Work proactively with Claims Assessors, claimants, medical professionals and 3rd parties to support claims assessment, minimizing end-to-end time and maintaining customer satisfaction.

Key Responsibilities:

• Gathering evidence and medically assessing information to accept or decline claims (complex, contentious, or sensitive).
• Displaying logical reasoning in various circumstances, including fraud, overseas issues, litigation, and liaison with managers, GFC, and legal services.
• Communicating with internal and external customers and third parties professionally and efficiently.
• Ensuring customer expectations are met by providing correct information and keeping them informed.
• Identifying appeals and complaints, investigating root causes, and escalating when required.
• Providing training, coaching, and technical support to team members.
• Contributing to claims projects, identifying issues, and recommending solutions.
• Applying Treating Customers Fairly (TCF) principles, outlining the claims journey, and managing expectations.

Qualifications:

• Experience as a Claims Assessor in terminal illness or critical illness claims.
• Experience assessing lump sum critical illness claims.
• Extensive knowledge of the full claims process, customer journey, and insurance products/policy conditions.
• Experience handling complex, contentious, refuted, or sensitive claims.
• Strong medical knowledge for claims assessment.
• Strong written communication skills for accurate customer communication and handling refuted claims.
• Experience communicating with reinsurers and medical officers.
• Ability to anticipate and resolve problems and prioritize workload effectively.
• Thorough understanding of ABI guidelines.
• Knowledge of legal aspects of claims (e.g., probate CIDRA).
• Comprehensive knowledge of financial calculations for claims payment.

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