TPA Claims Handler - Sedgwick Claims Management Services, Inc.

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A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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TPA Claims Handler

Role

TPA Claims Handler                                                         

Reporting

Property TPA Ops Manager 

Key roles

The role of the TPA Claims Handler is to provide a quality service to the customers of a leading Insurer, which meets or exceeds the Insurer’s expectations and generates the revenue to meet the demands of both Sedgwick’s and the Insurer’s businesses. The Claims Handler will be expected to deliver and perform day-to-day tasks pertinent to the team’s activity with a major focus on Quality, Accuracy, S.L.A’s, Procedures and Process-improvement. The team member will also be expected to provide effective cover and assistance to the Ops Manager.

Specific responsibilities

• TPA Team takes full ownership of claim Process for our Clients – FNOL to Claim Payment
• TPA Team also have different lines of business for our Clients which will be handled by the team
• Responsible for management of assigned desktop claims & delivery of target
• Provide effective and accurate advice to claimants based on a strong working knowledge of policy terms and conditions
• Review allocated cases and achieve settlement, within designated personal authority level, in line with established standards, procedures and guidance provided
• Manage customer interactions in an efficient, courteous and timely manner in order to deliver high standards of customer satisfaction
• Interact with customers directly and liaise with Insurer representatives to ensure the highest level of service and continuous operational efficiency
• Reviewing Loss Adjusters Reports , Referrals / Correspondence on Managed Accounts
• Authorisation of Payment with authority level
• Provide assistance where required in the training of new Team Members
• Maintain and update Personal Development Portfolio
• Ensuring that you achieve the minimum insurance standard qualification within the time frame and comply with CPD requirements where appropriate
• Successfully contribute to the development and delivery of the Team’s Goals, Objectives and Results
• Daily handling of a High-net-worth client, providing a concierge service, FNOL to completion on all claims and queries under this scheme. This High Net Worth covers a number if different business line – property, cyber, motor, HE travel with possibilities of additional lines to be added. Dealing with insurer directly and managing the portfolio

Qualifications/skills

• Minimum competency requirements APA or CIP Qualification desirable
• High level of proficiency in Word, Excel, and PowerPoint
• Sound numeric skills
• High level interpersonal and communication (verbal/written) skills

Personal attributes

• Sound knowledge of Sedgwick and its operation as a company (desirable but not essential)
• Willingness to operate flexible hours
• Capacity to work independently and demonstrate initiative
• Innovative
• Have a full working knowledge of CPC & Central Bank of Ireland Regulatory Requirements
• Willingness to work positively within a team environment with strong emphasis on support, flexibility and efficiency
• Understand how to organise work and think through how to get things done most efficiently with the ability to perform on their own initiative
• Strive to ensure Accuracy and Quality is delivered at all times
• Focus on skills development. Take action to improve own and others’ job skills
• Must have strong interpersonal and communication skills and be self-motivated, flexible and capable of working to critical deadlines

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.  They are not intended to constitute a comprehensive list of functions, duties, or local variances.  Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Sedgwick retains the discretion to add or to change the duties of the position at any time.