Technical Claims Specialist - Travel & Medical Claims
hace 16 días
Esher
About Healix At Healix, we safeguard people’s health and wellbeing worldwide. We provide 24/7 travel risk management, medical assistance, and claims services—supporting clients in complex, often critical situations across the globe. We’re now looking for a Technical Claims Specialist to join our Customer Operations team, playing a key role in managing high-risk, high-value cases and driving quality and consistency in claims decision-making. The Role As a Technical Claims Specialist, you will act as a senior escalation point for complex travel and medical claims—providing expert judgement, clear case direction, and ensuring fair, accurate outcomes. This is a highly collaborative role where you’ll work closely with medical teams, operations, insurers, and external partners, helping to shape decisions on some of the most sensitive and high-impact cases. What We’re Looking For • Proven experience in travel insurance claims and/or medical assistance claims, • Experience managing complex, high-value, and high-risk cases, • Strong understanding of: Medical repatriations and cost containment • Claims governance and regulatory requirements (e.g. CIDRA), • Ability to make sound decisions under pressure, • Confident stakeholder management across multiple teams and external partners, • Experience in complaints handling and resolution, • Highly organised with the ability to prioritise in time-critical situationsOur Values At Healix, how we work matters as much as what we do: • Put people first – we prioritise wellbeing and care, • Think independently – we use expertise and judgement to make the right decisions, • Earn trust – we act with integrity, transparency, and reliability Why Join Us?, • Work on meaningful, real-world cases with global impact, • Be part of a collaborative, expert-led environment, • Opportunity to develop and grow within a specialist function, • Exposure to international cases and stakeholdersApply Now If you’re an experienced claims professional looking to step into a technical, decision-making role with real impact, we’d love to hear from you. About The Role Key Responsibilities • Act as the primary escalation point for complex and high-value claims, • Provide clear case direction, decision rationale, and reserving for challenging cases, • Manage cases involving: High-risk scenarios (e.g. RTAs, adventure activities, vulnerable customers) • High-cost regions (e.g. USA and other global locations), • Complex medical conditions and repatriations, • Review and approve write-offs and escalations with clear recommendations, • Identify and pursue recovery opportunities, • Ensure decisions align with policy terms, CIDRA, and regulatory expectations, • Support complaint handling and resolution, • Contribute to continuous improvement of claims processes, • Build strong relationships with internal and external stakeholders, • Share insights and expertise to support wider teams and business performance Required Criteria • Proven experience handling complex travel or medical insurance claims., • Strong decision-making skills with the ability to assess high-risk, high-value cases., • Ability to work under pressure and prioritise in time-critical situations. Desired Criteria • Experience with medical repatriations and cost containment., • Knowledge of CIDRA and insurance regulatory frameworks., • Experience supporting complaints handling and process improvement. Skills Needed Company Culture Instead, we focus on ensuring our highly trained specialists have the space and time they need to be effective. We let them use their initiative to get the job done, because the situations they face often throw up unexpected challenges – and no protocol survives contact with the real world. Our clients have thousands of employees and customers, at home and abroad, so they need a business big enough to handle any situation. But they chose Healix because they also need an organisation that’s personal enough to care. Our people are driven to do things in the best way, not the way they have always been done. We work hard, and our efforts are rewarded with great development opportunities and a supportive team spirit. We want to nurture this friendly and dynamic company culture so that we can continue to attract diverse talent with a breadth of knowledge and world-class skills. As a part of Healix, you can expect a range of excellent benefits and an environment where people really do care. Company Benefits Commitment to career development We are committed to helping our people build and develop successful careers. Our employees are given direct responsibility and opportunity to develop and grow whilst working on challenging and worthwhile projects in a rewarding and supportive environment. We invest in the continuous development of our team, offering on-going training and professional enhancement opportunities for those wishing to diversify or take additional responsibilities. Health insurance, Vacation, Paid time off, Retirement plan and/or pension, Office perks, Employee development programs, Employee discounts, Gym membership or wellness programs, Opportunity to travel, Casual dress, Cycle to work, Free work laptop, Referral bonus, Open office, Competitive salary, Life insurance, Employee Assistance Scheme, Wellbeing Scheme, Social Opportunities, Progression opportunities Salary Not disclosed
