Contract: 12 Month Fixed Term Contract – Maternity Cover
We're looking for aComplaints Officerto join our Operations team on a12-month fixed-term contract. This is a varied and rewarding role where you will investigate complaints and fraud cases, helping to ensure fair outcomes for our members while protecting Health Shield from fraudulent activity.
Working within a regulated Financial Services environment, you will use your knowledge of complaint-handling requirements to manage investigations, identify root causes and support continuous improvement across the business.
You will work closely with colleagues, members, and external stakeholders, playing an important role in maintaining high standards of customer service, compliance and operational integrity.
This is an excellent opportunity for someone with a strong complaints handling background and investigative mind who enjoys problem-solving, making evidence-based decisions and driving positive customer outcomes.
What you’ll be doing:
- Investigating member complaints and ensuring fair, consistent outcomes
- Communicating effectively with members, healthcare providers and/or hospitals as appropriate to determine validity of claims
- Ensuring that any redress or remedial action required as a result of a complaint investigation is properly administered with actions recorded
- Collating comprehensive information relating to suspected Fraudulent claims, storing them in accordance with internal processes
- Maintaining accurate records and ensuring compliance with FCA and internal requirements
- Liaising with appropriate agencies to share information about investigations where applicable and protect Health Shield from avoidable losses
- Assisting with the development and implementation of checks and controls to prevent fraud or money laundering during the claims process
- Analysing reports to identify complaints trends, root causes and recommend improvements
- Supporting teams across the business through coaching and sharing best practice
- Contributing to complaint handling capability of front-line staff handling member contact by providing constructive feedback to Team Leaders
What we’re looking for:
We are looking for someone with a strong background in complaints, who is organised, analytical and passionate about delivering fair outcomes for members. You will be comfortable investigating issues, reviewing information and communicating clearly with a range of stakeholders.
- Experience working in financial services and a regulated business
- Experience of handling complaints in a regulated environment
- Demonstrable analytical, investigative and problem-solving skills, with the ability to gather, interpret and evaluate information objectively
- Excellent organisational and time management skills
- Experience in supporting operational areas with Complaints-related regulatory compliance
- Possess strong communication skills both written & verbal
- Well-organised, with a high attention to detail and ability to prioritise
- Possess a high level of confidentiality and discretion
- Computer & IT literate, knowledge of Microsoft applications
- Experience of regulatory complaints processing & liaison with the Financial Ombudsman Service
- Exposure to fraud investigations or fraud prevention activities is desirable, although training can be provided.
About Health Shield:
Health Shield is a regulated Insurance provider and is one of the leading companies in the Health Cash Plan market. Our Cash Plan products allow our Customers (and their staff) to claim for routine medical expenses – dental treatment, glasses, physio and are increasingly being seen as a key employee benefit. Our purpose is to help people lead healthier, happier lives and our people are key in achieving this. Our people goal is to create an environment where they are empowered, motivated, strive for excellence and conduct themselves with integrity.
Why Join Health Shield?
Our people are at the heart of everything we do. We are committed to creating a supportive, inclusive workplace where you can develop your skills, make a meaningful impact and be part of a team that genuinely cares about helping our members lead healthier, happier lives. Alongside a competitive benefits package, you'll enjoy flexible working opportunities, wellbeing support and a culture that encourages growth, collaboration and continuous improvement.
As part of our recruitment process, the successful candidate will be required to undergo and successfully satisfy a Basic Disclosure and Barring Service (DBS) check before employment can commence.
We are committed to creating an inclusive recruitment experience. If you require any reasonable adjustments at any stage of the recruitment process, please contact us and we will do our best to accommodate your needs.
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Complaints and Fraud Officer in Crewe employer: Health Shield Friendly Society Ltd
Health Shield is an exceptional employer that prioritises the well-being and development of its employees, fostering a supportive work culture where integrity and professionalism are at the forefront. With a focus on customer satisfaction and a commitment to empowering staff, employees can expect meaningful growth opportunities and a collaborative environment in which they can thrive. Located in a convenient area with benefits such as free on-site parking and a company pension, Health Shield stands out as a rewarding place to build a career in the health insurance sector.
Contact Details:
Health Shield Friendly Society Ltd Recruitment Team
