Healthcare claims associate - #1751546

Job Competency

• Maintain client relationships and ensure service standards adhered to by all providers, proactively interacting with clients, insurers, law firms, Adjusters and TPAs to facilitate efficient claim handling/procedures.


• Monitor all claims handling for allocated clients where claims are reported directly to insurers and where regular audits and large loss claim reviews are required.


• Manage those claims from first notification to settlement that require cradle to grave handling/advocacy attention.


• Assist in the design and implementation of bespoke claim procedures for clients.


• In partnership with the Claims Analyst, delivery of claims analysis reports identifying trends and discuss the findings and solutions with clients.


• Attending/leading regular claims meetings with clients, insurers, law firms and TPAs.


• Understanding and interpreting policy language and coverage

Experience/Skills:

• A strong track record of handling and investigating claims, preferably in the medical malpractice or healthcare field.


• Familiarity with medical terminology, legal principles, and regulatory requirements related to claims handling.


• Strong analytical and problem-solving skills to assess liability, quantum, and claim strategy.


• Ability to build and maintain strong relationships with clients and external partners.


• Excellent organisational, communication and presentation skills.