MEDICAL CLAIMS SPECIALIST

Dubai, UAE

About the Company

A leading Insurance Broker is looking for an experienced Medical Claims Professional to join their team in Dubai.

About the Role

To manage clients’ claims from notification to settlement in a professional and efficient manner, achieving an optimum result and complying with internal, regulatory and quality practice standards

Key Accountabilities / Core Competence Indicators:

Claims Settlement

  • Handle claims through first advice, investigation, negotiation and settlement.
  • Investigates, negotiates the settlement of claims to ensure an optimum client result and long-term client loyalty
  • Produces documentation to support the presentation of a claim for payment

Claims Communications

  • Maintains client communications and liaises with insurers and third parties
  • Notifies all appropriate layers and connected reinsurance to reduce the risk of rejection

Collection and Transfer of Settlement Funds

  • Process and issue payments to clients
  • Ensures prompt credit control, collection and transfer of funds with any appropriate third party notification

Wordings Advice

  • Assist placing colleagues by providing advice and interpretation on the claims implications of proposed wordings and terms.
  • Provides advice/statistics to Placing/Accounts on the possible impact of assured claims on renewals

Claims Information

  • Provides Claims Divisional management information (MI) on Claims statistics.
  • Gives Claims management timely advice of problems and emerging issues

Client Management

  • Identifies and manages client requirements in accordance with the terms of appointment
  • Builds and maintains strong client relationships
  • Achieves a high rate of client retention through well-planned and executed account renewal management
  • Ensures there are sufficient resources to meet client day-to-day demands and escalates servicing issues to divisional management as necessary
  • Ensure that the standards of the Company’s Client Service Charter are met at all times
  • No justified client complaints over provision of service

File Management

  • Maintains thorough and timely records of market negotiations, presentations and communications with insurers and with clients in accordance with Internal Procedures and informs clients and/or colleagues of any developments.
  • Ensure that correspondence, documentation, statistic etc. are retained on paper and electronic files in accordance with BPM and divisional procedures to demonstrate a complete audit trail.

Compliance/Corporate Governance

  • Legal, market, regulatory and Best Practice Manual requirements are met in all aspects of business acquisition, placing, claims and servicing.
  • High technical standards are maintained to achieve quality, minimal rework and minimal E & O exposure.
  • Maintain confidentiality in systems and procedures.
  • Financial & document checks and subsequent approval process is handled in accordance with the Company’s Authorised Signatory List.
  • Review files to ensure that correspondence, documents, statistics etc. are retained on file in accordance with Best Practice Manual/divisional procedures providing a complete audit trail
  • Supports the introduction of new processes in response to regulation changes.
  • Identifies and reports suspicious financial circumstances or transactions directly to the Company’s Money Laundering Reporting Officer

About the Individual

  • Bachelor’s degree in Insurance, Business Administration or equivalent
  • CII/ ACII Certification preferred
  • UAE or international market claims experience in either a broker or (re)insurer. Preferred exposure to large international corporations.
  • Market and industry structure and operation, including regulation and market reform
  • Electronic market claims systems
  • Sector specific risks and insurance products/solutions
  • Client servicing & Negotiation skills
  • Verbal and written communication
  • Accuracy and thoroughness FCA – Insurance Conduct of Business and Money Laundering/Prevention of financial crime
  • Claims process
  • Core IT systems: enter and retrieve information

Salary

Salary commensurate based on Candidates’ experience

Benefits

An excellent bonus scheme and other benefits

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Karan Seernani

Recruitment Associate

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