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Senior Medical Claims Assessor

4 months ago


Dublin Dublin Ireland Royal London Full time

Job Title: Senior Medical Claims Assessor

Control Function*: Yes

Contract Type: Permanent

Location: St. Stephen's Green, Dublin 2

Working style: Hybrid 50% home/ office based

Closing date: 7th May 2024

Royal London Ireland has achieved an increase in market share and as a result we are seeking applications for a Senior Claims Assessor to join our Underwriting and Claims team.

This is an excellent opportunity to join the largest mutual life, pensions, and investment company in the UK and contribute to our delivery of outstanding customer service.

As a Senior Claims Assessor, you will play a crucial role in the accurate and efficient assessment of Medical Claims made by our customers. With your exceptional analytical skills and attention to detail, you will review claims documentation, assess eligibility, and make fair and informed decisions.

About the role

  • Assess medical claims, including Death, Serious illness and Income Protection claims providing a quick and sensitive resolution.
  • Handle enquiries from brokers/medical staff and customers on an ad hoc basis.
  • Handle ombudsman enquiries and escalations.
  • Analysis of data and MI to support claims analysis.
  • Understand and documenting the Royal London claims process.
  • Accurately record claims within the claims database.
  • Train/Mentor junior team members in their role as Claims assessors and Claims administrators.
  • Management of a portfolio of income protection claims.
  • Quality sampling/Auditing of other team members.

About you

  • Experience assessing medical claims and a strong understanding of medical terminology.
  • Experience/knowledge of income protection products and claim assessment of Income Protection
  • Experience with claims documentation systems and providing MI/Data packs.
  • Utilising best methods of communication when gathering medical evidence
  • Experience requesting minimum amount of medical evidence required to make effective decisions.
  • Experience keeping customers fully up to date and ensuring satisfaction is met.
  • Understanding the full philosophy for claims for customers.
  • Strong communication skills both written and verbal.
  • Experience of leading/mentoring other team members
  • Holding or working towards one of the following: DLDU, QFA or APA qualifications

About Royal London Ireland

Based in our city centre location on St Stephen's Green in Dublin 2, Royal London Ireland is a fully owned subsidiary of the Royal London Mutual Insurance Society Limited, the largest mutual life, pensions, and investment company in the UK. We are authorised by the Central Bank of Ireland and provide protection products through Financial Brokers across Ireland. Our excellent customer service and mutual mindset means we take a longer-term view and focus on providing best customer outcomes.

Our People Promise to our colleagues is that we will all work somewhere inclusive, responsible, enjoyable and fulfilling. This is underpinned by our Spirit of Royal London values; Empowered, Trustworthy, Collaborate, Achieve.

We've always been proud to reward employees by offering great workplace benefits such as 28 days annual leave in addition to public holidays, up to 14% employer matching pension scheme contribution and a contribution to private medical insurance. You can see details of our benefits here - Our Benefits . Please note benefits for colleagues in the UK and Ireland may vary, please ask our team for details.

Inclusion, diversity and belonging

We're an Inclusive employer. We celebrate and value different backgrounds and cultures across Royal London. Our diverse people and perspectives give us a range of skills which are recognised and respected - whatever their background.

Central Bank of Ireland (CBI) Fitness & Probity Regime

Some of our roles are Control Functions (CF) as defined by the Central Bank Reform Act 2010 (Sections 20 & 22) Regulations 2011. If a vacancy is for a CF, it will be indicated above. For CF roles, appointment will be conditional on Royal London Ireland being fully satisfied that the appointee meets the requirements as set out in the Fitness and Probity Standards 2014 issued by the CBI. In the case of proposed appointees to Pre-Approval Control Functions, this includes prior approval by the CBI of such appointments.