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Claims Medical Specialist


  • Dublin City Centre
  • Not disclosed
  • Permanent full-time
  • Updated 21/12/2012
  • Jane Lanigan
this job is expired


Job Title: Claims Medical Specialist


Job Title: Claims Medical Specialist 

Aviva Role Level: C      

Reports to: Senior Claims Manager 

Company: Aviva Health Insurance Ireland Limited


Location:  Cork Airport Business Park or One Park Place, Hatch Street, Dublin 2


Duration: Permanent



This Role has been deemed CF6 under the Fitness and Probity Regime




Aviva Health is Ireland’s fastest growing provider of private health insurance and we are now seeking an ambitious and driven Claims Medical Specialist to join our Claims Department to assist in enhancing our capabilities and ensuring the effectiveness of our claims function. This is an ideal opportunity to move into an exciting and challenging role and to enhance your skills and develop your career within a very successful and ambitious company. 

The successful candidate will have a minimum RGN qualification with experience in hospital Administration or claims handling experience in Health and/or Life Insurance Company a distinct advantage. 

Key Responsibilities: 

  • Review high value/complex claims to ensure claims are paid in accordance with assessment rules and policy terms and conditions;
  • Identify and investigate and pursue opportunities for Claims Recovery;
  • Investigate anomalies identified through Claims Data Analysis and pursue recovery where appropriate;
  • Triage – Checking initial diagnosis and determining what services are required
  • Authorising medical tests, surgery, hospitalisation and scans, i.e. MRI/ CT
  • Authorisation of medical evacuation and medical repatriations.
  • Authorise claims up to a delegated level of authority.


  • RGN or similar qualification essential.
  • One of the following professional qualifications is an advantage – PMI Dip, ACII, CIP or QFA with a bridge to GI.

Skills / Competencies / Experience:

  • Experience in Health Insurance Claims not essential but a distinct advantage
  • Excellent verbal & written communication skills.
  • Efficiency in Word and Excel a requirement
  • An ability to work enthusiastically on own initiative and as part of a team to agreed deadlines.
  • Excellent interpersonal & co.....

    To view the full job description, please click the link below

Ref: 807623
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