Insurance Case Coordinator - Galway

CPL

Galway

Our Client, a Galway based Insurance company seeking an Insurance Case Co-ordinator to join their team. In this pivotal role, the Insurance Case Co-ordinator will be responsible for the accurate and timely processing of Medical Claims ensuring policy benefits, billing, eligibility, coverage and other related information are handled within the Company standards and best practices guidelines. Duties: Review guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. • Prepare and send written communication to our customers once cover has been determined. • Daily review of new claims ensuring claim has been assigned and reserved accurately in claims system. • Co-ordinating updates on potential high cost claims, VIP claims, complex assistances, rejections and any relevant decision on the disposal of such claims to TCC (Top Claims Committee. • Utilize critical thinking skills to discover better ways of working and resolve complex problems in a team environment. • Technical support to the Claims Team Manager, Operations Manager and Supervisors. • To report any suspected incidents of fraud and corruption, maintaining a register of suspected and proven cases. • Regular review of reserves, ensuring claims are accurate and report on Monthly / Quarterly and Annual Basis to TCC (Top Claims Committee. • To develop and deliver regular basic claims training to both new employees and existing staff in travel products. • To regularly review and maintain knowledge levels for the job and keep up- to-date with departmental operational changes. • To communicate clearly, accurately and effectively with internal and external customers. • To deal with the telephone calls in a customer-focused way, ensuring that service levels and standards are maintained. • Register and maintain Outpatient Cases. • To make a positive input to the team’s effectiveness, so that work systems and processes are altered and improved. • Identify and ensure Recovery is followed up. • To work with Claims Team Manger to monitor and control Leakage. • To adhere to the Company’s procedure in accordance with the Consumer Protection Code and all relevant Data Protection regulations. • To undertake any other duty or responsibility that may reasonably be allocated either by the. • The successful candidate must have achieved or be working towards APA qualification. • Minimum of 1 years’ claims experience. • Ability to increase productivity and continuously improve methods, approaches, and departmental contribution. Commitment to continuous learning. • Technical knowledge of typical travel insurance products a distinct advantage. • A good knowledge and understanding of the insurance market, the basic insurance principles and the ability to apply them. • Excellent written and verbal communication skills. • Good planning and organisation skills in order to meet timescales. • Good numerical skills and literacy skills including Microsoft Office suite. For more information, contact Enda Feighery enda.feighery@cpl.ie 0870955459/091507511. This job originally appeared on RecruitIreland.com.

2178 days ago