Call and Correspondence (including Electronic Mail) Handling
Handle all customer calls and emails enquiries promptly and efficiently
Ensure delivery of exceptional customer experience throughout all communication channels
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
Accurately record case data and ensuring proactive case progression
Claims Assessments
Proactively handle all claims assigned optimising ongoing file ownership, where possible, to final resolution.
Assess claims promptly and efficiently using up to date and most appropriate methods such as tele-claims and conversational claims
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
Effectively communicate decisions to customers and provide a clear and understandable explanation of claims decisions and case status
Handle complex cases and customer complaints within business guidelines, escalating cases in line with departmental processes
Investigate and / or referral of potentially fraudulent claims o Take all steps and precautions to minimise leakage
Preparation of quotes for dental treatment plans o Liaison contact with network dental practices
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.
Knowledge, skills and experience required
Requirements
Excellent verbal and written communications skills
Numeracy and literacy to include relevant PC skills - Work & Outlook (essential), Excel (desirable) with accurate and quick keyboard skills
Commitment to Customer Centricity
Strong empathy with professional and sensitive client approach - Effective listening skills
Excellent call handling & interpersonal skills/influencing and negotiating skills
Good attention to detail and able to work accurately to meet strict deadlines and targets
Exceptionally quality driven
Excellent decision-making skills
Ability to strike a balance between demonstrating empathy with the customer whilst conscious of the need to settle claims in accordance to policy wordings
Ability to remain composed and professional, whilst focusing on the customer when under pressure
Strong time management and ability to manage high volume workload
Adaptable to change with flexible approach to daily department tasks and working hours
Assertive and confident in dealing with people at all levels
An effective team worker who demonstrates an ability to take ownership and responsibility for resolving issues / problems
Ability to increase productivity and continuously improve methods, approaches and departmental contribution
Strong work ethic
Commitment and drive for continuous learning
Educational Requirement
Must be working towards or a qualified APA qualification as a minimum insurance educational requirement
About us: Our story
Collinson Group is a global leader in driving loyalty and engagement for many of the world's largest companies. Predominantly through the provision of travel related benefits within a market leading digital travel ecosystem. The gro
Benefits
Dental insuranceVision insuranceFlexible schedule
Additional Information
Recruiter for this role:
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