Claims Assessor

The Team You Will Join

You will be joining the Individual Protection Team. The team is a vibrant and supportive team who prides itself on working collaboratively with each other and our Stakeholders, such as the Customer Service, Sales and Complaints teams. The team has a wealth of knowledge and years of experience with our products and Claims assessment with the majority of the team being Senior Claims Assessors. Our focus is to give the customer the best Claims experience, through innovative improvements, delivering on the promise and providing excellent service.

The Opportunity

The 12-month FTC Individual Protection Claims Assessor will contribute to the proactive management of claims administered by MetLife, providing reassurance to customers through service excellence and accuracy of work. This is an exciting opportunity for Claims Assessors to develop and maintain strong relationships with internal and external customers. Success in this role requires excellent communication and interpersonal skills. The Claims Assessor is responsible for claims assessment and all duties associated along with telephone call handling. You’ll collaborate closely with Customer Service, Sales and Complaints teams in an environment where every contribution is respected, and every perspective is heard.

How You’ll Help Us Build a Confident Future (Key Responsibilities)

• Fast Track claims assessment: Responsible for the claim assessment, decision making and customer communication within agreed controls on fast track claims. Ensure that work is completed to required quality standards within agreed timeframes. Ensure that claims not meeting fast track criteria are identified and triaged appropriately. This role requires the ability to make claim liability decisions within the agreed controls; the role holder is expected to demonstrate the ability to review information, analyse and be decisive.
• Other claim assessment: As required by the Claims Managers there will be an expectation to assess non-fast track claims within a set remit. Ensure that work is completed to required quality standards within agreed timeframes. This role requires the ability to make claim liability decisions within the agreed controls; the role holder is expected to demonstrate the ability to review information, analyse and be decisive. This will require telephone conversations with customers about claim decisions, some of which will be giving decisions about negative claim outcomes for the customer.
• Med Fee Authorisation: Responsible for checking med fee payments raised by the Claims Administrators, to ensure timely and accurate payment of all med fees. In accordance with MetLife UK Governance you will also carry out quality checking and sampling of these with results recorded.
• Telephone Call Handling: Receiving and handling all incoming telephone calls efficiently and professionally with regards to claims. Responsible for complying with caller Data Protection checks. All calls to be handled in line with the MetLife UK Operations framework, for technical accuracy and telephone manner. Records of all calls to be maintained on the relevant systems.

What You Need to Succeed (Required Qualifications)

• Administration experience gained in any of the following departments: claims/legal/fraud. This will allow you to be able to deal with claims that include hospitalisation, broken bones & funeral benefits.
• Will be exposed to detailed written or visual medical records, which may include detailed police reports. Must be able to show resilience and be able to desensitise.
• Competent and professional demeanor, able to deal in the correct manner with internal & external customers as well as third parties such as GP’s, hospitals and Police.
• Good, polite telephone manner and letter writing required.
• Able and happy to work from our Brighton HQ one day a month, after the initial period of training and integration in the team which will require presence in the office every day (5 days). This should last about a month.
• Will be able to commit to a 12-month fixed term contract.

What Can Give You an Edge (Additional Skills)

• A medical or claims background that would allow for dealing with the more technical type of claim such as child cancer, loss of use, amputation & accidental death; experience would be advantageous but not essential as training will be provided.
• Previous experience with an autonomy limit in the payment of claims would be ideal however not necessary as we do have training procedures in place for the correct candidate to gain autonomies.