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Join Our Team as a Technical Claims Manager! We are thrilled to announce an exciting opportunity for a Technical Claims Manager. Reporting directly to the Head of Technical Claims, this role will primarily focus on overseeing and managing high-value medical claims handled by a third-party provider. Your responsibilities will include advising on and approving these large claims, as well as performing regular reviews and checks on the third-party claims handler to ensure excellent customer service and effective claims cost management. Additionally, you will provide technical claims support to our in-house claims team, so a solid understanding of travel products is essential. We are looking for a candidate with prior experience in managing similar claims, preferably in the travel medical assistance sector. You should be an ambitious and enthusiastic individual, capable of working independently while also sharing your expertise with others. The claims environment is fast-paced, requiring quick decision-making on complex claims. Comfort in swiftly establishing the facts of each case is crucial for effective outcomes. This is an exciting time for our travel claims operation, as we are experiencing growth. Your role will be pivotal in ensuring strong controls and oversight for our highest-risk claims, ultimately leading to positive customer outcomes and effective cost management. We are transitioning to a hybrid working model that blends office and remote work. While we prioritise finding the right candidate with the necessary skills and experience, we are open to discussing a flexible arrangement that balances time in our Cardiff office with remote work options.
Job Responsibility
Oversee large-value medical claims beyond supplier authority, reviewing coverage and collaborating with medical providers
Handle emergency calls for claims decisions after hours, ensuring readiness for significant decisions on high-value claims
Conduct audits on supplier claims processes to ensure effective management, providing feedback and challenging as needed
Identify cost-saving opportunities during case management, pursuing innovative approaches to stand out from competitors
Stay updated on travel insurance market developments, attending conferences to identify challenges and competitors
Share market knowledge and expertise with colleagues to support their development
Manage communication with stakeholders on high-value claims for informed decision-making and optimal outcomes
Requirements
A minimum of three years' experience handling medical claims within a travel claims context
Preferably possess CII or equivalent qualifications, demonstrating commitment to continuous learning
Strong experience in travel insurance claims, especially medical assistance
Solid understanding of medical claims validation and policy application
Experience managing external medical suppliers and influencing performance
Excellent analytical skills for assessing complex cases and identifying trends
Ability to use performance data to improve outcomes and control costs
Outstanding communication skills for collaboration with stakeholders
Capable of sharing technical knowledge and mentoring team members
Confident in making technical decisions on complex claims
Good understanding of claims governance and regulatory requirements
Skilled at managing competing priorities in a dynamic environment
Proficient in Microsoft Office and claims management systems
Adaptable and committed to ongoing personal and professional development
What we offer
Up to £3,600 of free shares each year after one year of service
33 days holiday (including bank holidays) when they join us, increasing the longer you stay with us, up to a maximum of 38 days (including bank holidays)
Option to buy or sell up to an additional five days of annual leave