Claims Adjuster - Medical Malpractice

Primary Details

Time Type:
Full time

Worker Type:
Employee

The purpose of this role is to deliver exceptional claims services by determining policy coverage, investigating, evaluating, and negotiating assigned cases, as well as providing timely and accurate support for high complexity claims management with a particular focus on clinical negligence claims.

Leeds/Hybrid

At QBE, we get to the heart of what matters for our customers. And we do it all with a human touch.

We’re an international insurer with more than 13,000 people working across 26 countries – which means we’re big enough for your ambitions, yet small enough for you to make a real impact. It’s an exciting time. We’re building momentum towards our vision to become the most consistent and innovative risk partner.

What if you could have a positive impact – at work and in the world? As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind.

Please note - Applicants must have the right to work in the UK as visa sponsorship is not available for this role.

We are recruiting for a Claims Adjuster within the FSM claims team with a particular focus on Medical Malpractice claims. You will be expected to demonstrate technical expertise in more than the Medical Malpractice line of business, including professional negligence claims. You will investigate, manage and resolve more complex claims accurately and pro‑actively, and within SLA’s and agreed authorities.

• Investigate, manage, and resolve Medical Malpractice, professional negligence and Healthcare claims efficiently and in a timely manner.
• Ensure adherence to SLAs and authority limits while managing claims.
• Support the implementation of the Claims strategy to enable delivery of overall business targets.
• Identify and investigate coverage issues to ensure that the company’s liability is in line with its contractual commitments.
• Reserve accurately to ensure that the Company’s liability is always clear.
• Ensure that messages, advice, and correspondence, are responded to pro‑actively and within agreed time frames to provide a professional service to brokers and clients.
• Proactively manage estimates and billings calculated by client’s service providers and brokers resolving any discrepancies.
• Regular interactions with key stakeholders including our customers, brokers and internal partners.
• Manage disputed Claims and other material Claims issues in order to resolve and settle claims on an economic basis.

• Experience in handling Medical Malpractice claims.
• Preferable experience of handling professional negligence claims.
• Competent in relevant Claims Systems.
• Current knowledge of compliance, regulatory and statutory requirements.
• Organisational, investigative, analytical and negotiation skills.
• Ability to make balanced and impartial judgements.
• Excellent communication and presentation skills.
• Relationship Management skills.
• Able to use MS Office applications and strong IT skills.

• 30 days holiday a year with the option to buy up to 2 additional days.
• Flexible working – balancing work and life is important so our flexible working opportunities are open to all, this can include part‑time, job share and compressed hours.
• Pension – you are automatically enrolled into the QBE pension plan, which entitles you to receive employer contributions of 10% of your basic salary.
• Private medical insurance – we fund fully comprehensive private medical cover for you and all the family.
• Family friendly policies – we offer 26 weeks leave at full pay regardless of gender identity, sexual orientation or how you become a parent.
• Short term remote work abroad – you can request up to 20 days per year to work remotely from certain locations abroad.
• Sustainable investing – we believe sustainable integration is important for long term financial, environmental, and social outcomes. Our pension strategy supports our net‑zero goal to achieve year‑on‑year reductions in carbon footprint, by investing more in green businesses than the broader market, so your savings are looking after the planet's future, as well…