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.
Main Duties
* 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.
Experience and Qualifications Required
* 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.
Skills
* 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.
Benefits
Everyone receives 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). You also have the option to buy or sell up to an additional five days of annual leave. The company offers up to £3,600 of free shares each year after one year of service.
Equal Opportunity and Reasonable Adjustments
We take pride in being a diverse and inclusive business. We are committed to fostering an inclusive culture where everyone is accepted, supported and empowered. We are Disability Confident and will invite a fair and proportionate number of candidates that meet the essential requirements of the role to the first stage of our selection process. Reasonable adjustments and support will be provided throughout the recruitment process.
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