Technical Medical Claims Manager - Travel

Job Description

Join Our Team as a Technical Claims Manager!

We are thrilled to announce an exciting opportunity for a Technical Claims Manager. Reporting directly to the Head of Technical Claims, this role will primarily focus on overseeing and managing high-value medical claims handled by a third-party provider. Your responsibilities will include advising on and approving these large claims, as well as performing regular reviews and checks on the third-party claims handler to ensure excellent customer service and effective claims cost management. Additionally, you will provide technical claims support to our in-house claims team, so a solid understanding of travel products is essential.

We are looking for a candidate with prior experience in managing similar claims, preferably in the travel medical assistance sector. You should be an ambitious and enthusiastic individual, capable of working independently while also sharing your expertise with others.

The claims environment is fast-paced, requiring quick decision-making on complex claims. Comfort in swiftly establishing the facts of each case is crucial for effective outcomes. This is an exciting time for our travel claims operation, as we are experiencing growth. Your role will be pivotal in ensuring strong controls and oversight for our highest-risk claims, ultimately leading to positive customer outcomes and effective cost management.

We are transitioning to a hybrid working model that blends office and remote work. While we prioritise finding the right candidate with the necessary skills and experience, we are open to discussing a flexible arrangement that balances time in our Cardiff office with remote work options.

Main Duties

• Oversee large-value medical claims beyond supplier authority, reviewing coverage and collaborating with medical providers.
• Handle emergency calls for claims decisions after hours, ensuring readiness for significant decisions on high-value claims.
• Conduct audits on supplier claims processes to ensure effective management, providing feedback and challenging as needed.
• Identify cost-saving opportunities during case management, pursuing innovative approaches to stand out from competitors.
• Stay updated on travel insurance market developments, attending conferences to identify challenges and competitors.
• Share market knowledge and expertise with colleagues to support their development.
• Manage communication with stakeholders on high-value claims for informed decision-making and optimal outcomes.

Experience and Qualifications Required

• A minimum of three years’ experience handling medical claims within a travel claims context.
• Preferably possess CII or equivalent qualifications, demonstrating commitment to continuous learning.

Skills

• Strong experience in travel insurance claims, especially medical assistance.
• Solid understanding of medical claims validation and policy application.
• Experience managing external medical suppliers and influencing performance.
• Excellent analytical skills for assessing complex cases and identifying trends.
• Ability to use performance data to improve outcomes and control costs.
• Outstanding communication skills for collaboration with stakeholders.
• Capable of sharing technical knowledge and mentoring team members.
• Confident in making technical decisions on complex claims.
• Good understanding of claims governance and regulatory requirements.
• Skilled at managing competing priorities in a dynamic environment.
• Proficient in Microsoft Office and claims management systems.
• Adaptable and committed to ongoing personal and professional development.

Admiral: Where You Can

We take pride in being a diverse and inclusive business. It's a place where you can Be You, and show up as you are. We’re committed to fostering a people-first culture where everyone is accepted, supported, and empowered to be brilliant. You can, Grow And Progress at a pace and direction that suits you, Make A Difference for our customers and each other, and Share in Our Future with all colleagues eligible for up to £3,600 of free shares each year after one year of service.

Everyone receives 33 days holiday (including bank holidays) when they join us, increasing the longer you stay with us, up to a maximum of 38 days (including bank holidays). You also have the option to buy or sell up to an additional five days of annual leave.

We’re proud of our people-first culture. In fact, we've been recognised as a Great Place to Work for Women, a Great Place to Work for Wellbeing, and an overall Great Place to Work for over 25 years! We’re fully committed to making sure your progression is not slowed or halted by barriers related to race, gender, age, sexuality or any of the protected characteristics.

Our fantastic benefits make sure our colleagues have a great work-life balance; You can view some of our other key benefits here.

Disability Confident Leader

As a Disability Confident Leader, for candidates with a disability or long-term health condition, that opt into the Disability Confident scheme, we’ll invite a fair and proportionate number of applicants that meet the essential requirements of the role to the first stage of our selection process.

If you need any adjustments or support with your application or during the recruitment process, just let us know. Please do email Samantha Bevan or contact us on 07443573168.

This number is dedicated to supporting candidates that require reasonable adjustments or support during the application process.

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