Claims Audit Consultant

34000.00 - 41000.00 GBP Annual + GBP34000 - GBP41000/annum
11 Apr 2017
26 Apr 2017
Contract Type
Full Time
We are working with a leading life insurer in Brighton that is looking to hire a Claims Audit Consultant. You will be responsible for end-to-end audits of income protection and critical illness claims appeals and decide whether to accept or reject the decison made.

Role Responsibilities:

* Provide a comprehensive assessment of Income Protection and Critical Illness claims appeals, deciding whether to accept or reject the appeal
* Conduct and deliver regular monthly audits of the decisions made by the benefits teams in relation to the Workplace Health and Protection products
* Deliver processes and systems to ensure that a consistent, acceptable level of service is provided to customers, that complaints and Financial Ombudsman Service (FOS) cases are handled fairly
* Develop, document and review our benefits philosophies, techniques & practices, reviewing competitor activities,
* Maintain an expert level of knowledge on all technical benefits issues and regulatory/legislative issues
* Compile & analyse statistical data and case studies to identify trends and produce & circulate reports and feedback to appropriate managers, individuals and group forums relating to findings and claims activity
* Undertake a technical development role, representing the benefits and medical underwriting area, when new business opportunities arise
* Define, develop & deliver processes & systems to ensure that all customer data is dealt with appropriately

Skills Required

* Strong knowledge of life insurance products including income protection and critical illness
* Strong audit capabilities with the ability to provide concise feedback to senior management and handlers
* Strong working knowledge of legislative and regulatory aspects including Finance Act 2004, Equality Act (2010), Employment Law, HMRC rules relating to Life and Pensions products and Access to Medical Reports Act
* Excellent communication, both verbal and written, skills; analytical and risk management skills.
* Good understanding of medical conditions and the effect these can have on an individual's ability to work
* Awareness of the investigative and rehabilitation services provided by external organisations
* Degree educated preferred but not essential

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