TPA Claims Handler

Key roles

The role of the TPA Claims Handler is to provide a quality service to the customers of leading Insurers, 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 Team Leader.

Specific responsibilities (including but not limited to)

• 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 PL 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
  

Benefits of working for Sedgwick in Ireland

• Bike to Work Scheme

• Tax Saver Travel Scheme

• Discounted onsite Gym Membership (Dublin 4)

• Discounted onsite Montessori (Dublin 4)

• EAP – Employee Assistance Programme

• Health Insurance Scheme

• Life Cover

• PHI – Permanent Health Insurance

• Exams & Professional Membership Fees

• Professional and personal development opportunities
  

Sedgwick Ireland is regulated by the Central Bank of Ireland (CBI). This role is subject to the Minimum Competency Code (MCC) as set out by the CBI. This code sets out the minimum professional standard for any person providing certain financial services, in particular when dealing with consumers. This role is classified as a Controll ed func tio n ( CF5, CF6 ) a nd is subject to Fitness and Probity Standards, including the requirements outlined in the Individual Accountability Framework Act 2023. Successful candidates will receive training in relation to all regulatory requirements applicable to them.