Call and Correspondence (including Electronic Mail) Handling
o Handle all customer calls and emails enquiries promptly and efficiently
o Ensure delivery of exceptional customer experience throughout all communication channels
o Obtain all necessary information from the caller to register new claims and secure an accurate understanding of the claims circumstances and inform the client, in accordance with department guidelines, of the correct procedures to submit or progress a claim
o Accurately record case data and ensuring proactive case progression
Claims Assessments
o Proactively handle all claims assigned optimising ongoing file ownership, where possible, to final resolution.
o Assess claims promptly and efficiently using up to date and most appropriate methods such as tele-claims and conversational claims
o Investigate, negotiate and settle claims within an agreed authority level, KPIs and timeframes, ensuring fair settlement of valid claims, referring to any applicable Claims Philosophy outlined by departmental processes
o Effectively communicate decisions to customers and provide a clear and understandable explanation of claims decisions and case status
o Handle complex cases and customer complaints within business guidelines, escalating cases in line with departmental processes
o Investigate and / or referral of potentially fraudulent claims o Take all steps and precautions to minimise leakage
o Preparation of quotes for dental treatment plans o Liaison contact with network dental practices
o To escalate Network issues as appropriate with full case background
Promote the best image of the Company through a professional manner, personal appearance and behaviour and adhere to company standards and procedures. Maintain the highest level of personal conduct
Understand and follow departmental procedures and processes and participate in initiatives and contribute to the continuous development of the claims process by identifying opportunities for product development and process improvement.
Accurately report and adhere to quality and KPI metrics on a monthly basis by implementing development needs as communicated by the Quality Team
Develop and utilise specialist knowledge, skills and appropriate behaviours to achieve a successful case outcome
Maintain a good understanding of the claims IT systems
Maintain a good knowledge of policy wording, underwriters' approaches and their application to claims
Ensure compliance with FCA, Central back of Ireland and regulatory requirements, including adherence to the Consumer Protection Code, as well as DPA and GDPR
Provide back-up and support to other Operational functions as required
This job description is not exhaustive and is intended to be a guide to the principle duties of the post only. It may be amended at any time with the agreement of the post hold and line manager.
Knowle
Benefits
Dental insurance
Additional Information
Recruiter for this role:
Job title Call Claims Handler
Location Kells
Department Travel/Dental Claims
Reporting to Operations Team Leader
Collinson is a global loyalty and benefits company.
We use our expertise and products to craft customer experiences which enable some of the world's best known brands to acquire, engage and retain the most demanding and choice-rich customers. In particular, our unique expertise and insight into high earning, frequent travellers allows us to create products and solutions for our clients that inspire greater customer engagement to drive more profitable relationships, enrich their travel experiences, protect what matters and assist in in times of need.
While specialising in Financial Services, Travel and Retail, we also support clients in multiple sectors. We have worked with over 90 airlines, 20 hotel groups and more than 600 financial institutions and banks, with clients including Accor Hotels, Air France KLM, American Express, British Airways, Cathay Pacific, Diners Club, Mandarin Oriental, Mastercard, Radisson Hotel Group, Sephora, Visa and Vhi.
We take our 30 years' experience working with these kinds of household names in over 170 countries, and help our clients to deliver the smarter experiences it takes to differentiate their propositions, and help them win deeper devotion with their customers.
Collinson is a privately-owned entrepreneurial business with 2,000 passionate people working in 20 locations worldwide. Our solutions include Priority Pass, the world's best known airport experiences programme, while we are also the trusted partner behind many of the leading financial services, airline and hotel brand's reward programmes and loyalty initiatives.
Purpose of the Job
To assess and settle dental insurance claims promptly and efficiently, whilst providing an excellent
level of customer service at all times, maintaining high standard of customer engagement through prompt and proactive responses to all claims phone and email queries, whilst adhering to strict
deadlines and service level agreements.
Collinsongroup · Kells