Claims Manager - Third Party Complex Job at Social Value Portal Ltd (London)

Manager, R&D Claim Enquiry & Resolution

This is a critical, high-impact role responsible for safeguarding the claims of ...

Location

United Kingdom , London

Salary:

Not provided

EmpowerRD

Expiration Date

Until further notice

Requirements

Proven experience (3+ years) in UK R&D Tax Relief, with significant exposure to managing and successfully resolving HMRC enquiries or compliance checks
Strong technical understanding of R&D tax legislation (including SME and RDEC schemes) and the Department for Science, Innovation and Technology (DSIT) guidelines on R&D for tax purposes
Demonstrable experience in managing complex projects or a high-volume case portfolio simultaneously
Excellent written and verbal communication skills, specifically the ability to articulate complex technical and financial concepts to both HMRC and non-tax professionals
Strong commercial acumen and a pragmatic approach to dispute resolution

Job Responsibility

Manage the end-to-end portfolio of all active HMRC R&D tax credit enquiries, ensuring all statutory deadlines and internal SLAs are met
Develop, implement, and execute robust enquiry defence strategies for complex claims, focusing on technical and financial justifications in line with UK R&D legislation (CTA 2009/HMRC Guidelines)
Own and lead direct written and verbal correspondence and negotiations with HMRC caseworkers (ISBC/WMBC/Large Business Compliance Teams) to achieve timely and favourable closure notices
Review and quality-assure all documentation and supporting evidence (technical narratives, project costing, payroll, contracts) provided to HMRC to ensure it is clear, comprehensive, and addresses specific compliance risks
Manage and cultivate a flexible bank of external expert contractors (e.g., specialist engineers, sector-specific consultants, legal counsel) who can provide specialised technical evidence and support during enquiries
Define scopes of work, manage budgets, and oversee the output of all third-party experts to ensure their contribution aligns with the overall resolution strategy
Lead the internal feedback loop by analysing trends, common errors, HMRC concerns, and legislative risks identified during enquiries
Develop and deliver training sessions to the Claim Delivery and Sales teams, embedding new learnings and best practices back into our claims process and technology product
Proactively refine and update internal methodology and technical guidance to mitigate future enquiry risk and ensure all new claims are resilient and compliant
Support in reviewing technical narratives of ongoing claims to align with enquiry learnings

What we offer

Competitive salary
generous holiday allowance
pension contribution
private healthcare
a commitment to continuous professional development

Fulltime

Private Motor Claims Handler

An excellent opportunity is available with our client in the insurance sector. W...

Location

United Kingdom , London

Salary:

35000.00 - 40000.00 GBP / Year

Lawes Consulting Group

Expiration Date

Until further notice

Requirements

Skilled in liaising with clients, third parties, and suppliers, explaining claims processes clearly
Able to gather and assess information while managing multiple claims
Empathetic and professional in addressing customer needs
Proficient in problem-solving to resolve claims efficiently
Detail-oriented with strong IT skills, including claims management systems
Experience in handling motor insurance claims, including the investigation and resolution of accidents, losses, and damages
Ability to form positive relationships with clients, third parties, and suppliers

Job Responsibility

Manage motor claims, including accidents, uninsured loss recovery, third-party interventions, personal injury, theft, and property damage
Gather claim information from policyholders, third parties, emergency services, and witnesses
Investigate claims with a calm, empathetic approach, reviewing policy details for validity
Monitor external suppliers to ensure timely and accurate service
Collaborate with specialists for complex claims and ensure efficient, fair resolutions
Keep clients and stakeholders regularly updated on claim progress

Fulltime

Complex Claims Manager

The AirCover team is charged with ideating, building, launching, and managing th...

Location

United States

Salary:

100000.00 - 115000.00 USD / Year

Airbnb

Expiration Date

Until further notice

Requirements

Analytical: Possess excellent analytical and problem-solving skills, allowing you to navigate Complex and Large Loss claims identifying the Risk and Exposure to Airbnb
Strong knowledge complex complex resolution: Understand techniques, investigative methodologies, and legal aspects related to complex, severe claims resolution
Strong communication: Strong verbal and written communication skills, with the ability to explain complex topics to diverse audiences. Skilled in presenting complex and sensitive customer issues, with the ability to analyze large data sets and draw reasonable conclusions
Influence Airbnb cross-functional teams globally: Proven ability to collaborate effectively across disciplines, regions, and seniority levels. Strong negotiating skills and experience in communicating recommendations to both internal and external stakeholders
Judgement
Proactively work towards achieving a fair and suitable resolution for claims in a timely manner by employing effective conflict resolution strategies
Evaluate and interpret policy language and relevant case law alongside specific loss details to make informed coverage decisions
Coordinate loss investigations with external experts across various exposures and manage the adjustment process until final resolution
Determine liability swiftly and judiciously based on available information, showcasing effective critical and strategic thinking along with sound decision-making
Be an advocate of high quality standards, innovation, resolution conflict and customer experience excellence

Job Responsibility

Safeguard the integrity of our Aircover platform by effectively identifying, investigating, and managing the risk and mitigation strategies in resolution of Complex and Large Loss claims
Manage partners to influence prioritization, drive accountability, deliver improvements, and scale changes on claims which impact Airbnb
Work with internal and external partners to influence prioritization, drive accountability, and deliver improvements
Work closely with cross-functional teams to manage emerging risks / threats while enabling business growth in various markets
Identify intelligence / risk gaps and work with other internal risk management teams, third party adjusters, our partners, Platform Product Management, Global Crisis Management, Community support, Policy, Privacy Legal teams to strengthen Airbnb’s platform
Report at Monthly, Quarterly and Annual Business Reviews for your area
Serve as a thought leader with stakeholders such as Trust, Legal, Privacy, Safety, Product Management, Policy, and understand how the policy/product roadmap impacts risk mitigation of emerging threats
Management, Policy, and understanding how the policy/product roadmap impacts risk and exposure mitigation
Build partnerships and is responsible for engaging in the Large Loss Claim reviews with our insurers on a monthly / quarterly basis depending upon the insurer/market
Ensure we are managing insurers claim handling and potential coverage/relationship issues as well as material reserve changes that could impact Airbnb and the Captive

What we offer

Bonus
Equity
Benefits
Employee Travel Credits

Fulltime

Senior Loss Adjuster – Major / Complex Loss

This is a great opportunity for an experienced Adjuster to make their mark withi...

Location

United Kingdom , Southampton / Hampshire

Salary:

65000.00 - 90000.00 GBP / Year

Lawes Consulting Group

Expiration Date

Until further notice

Requirements

ACILA or similar with the desire to continue learning and /or full qualifications
Extensive knowledge and understanding of FSA procedures and TCF initiatives
Extensive technical knowledge within the adjusting arena at a complex loss level
Understanding of Client SLA compliance/productivity/quality requirements
Able to embrace technology and be proficient in MS office suite
The ability to influence key personnel as to give the product a competitive edge
Someone who can inspire others to deliver excellent service to differing people, with differing expectations, in a range of commercial environments
A sound understanding of financial aspects coupled with the ability to lead others to achieving agreed targets
A full UK driving licence, with the willingness to travel to regional offices when required
A high achiever, capable to presenting the product to its best advantage

Job Responsibility

Managing the more technical and complex claims ranging from flood damage resulting in Business Interruption to claims associated with catastrophic event
Delivering a high quality, professional service to clients
Managing an active caseload of predominantly commercial claims over 100k in value, often containing material damage and business interruption matters
Working with other business streams and third parties, such as our Casualty/Liability team or local government and emergency services

What we offer

Package

Fulltime

Lead Pharmacy Technician

Lead Pharmacy Technician position in Menomonee Falls, WI. Oversees pharmacy tech...

Location

United States , Menomonee Falls

Salary:

25.30 - 37.95 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Licensure (IL only): State of Wisconsin (registration): Pharmacy Technician or Pharmacy Technician Student
Certification (CPhT) issued by PTCB or ExCPT within two years of hire, or sooner if required by law. Must sit for the certification exam at least one time within the first year of employment.
Patient facing teammates may be required to have three certifications: Immunization, BLS through an entity approved by Advocate Health and non-vaccine injectable to be granted from the state of WI or if from out of state, the program is approved by the accreditation council for pharmacy education (ACPE) or by the WI pharmacy examining board.
High School Graduate.
Typically requires 3 years of experience in a pharmacy technician position that includes experience with third party insurance or Medicare within a retail environment.
Demonstrated leadership skills such as delegation, team building, managing multiple priorities, problem solving, and decision making.
Demonstrated knowledge of medication usage to appropriately identify the correctness of billing as well as appropriateness of medications for processing.
Ability to understand and become knowledgeable of pharmacy standards, policies, procedures, and Health Insurance Portability and Accountability Act (HIPAA) regulations.
Intermediate computer skills including the ability to navigate through a database and run reports. Proficient keyboarding skills and previous experience with Microsoft Office products, electronic mail and/or electronic health information records systems.
Excellent communication (written and verbal) skills.

Job Responsibility

Oversees the activities of the pharmacy technician staff to ensure timely completion and accuracy of work. Acts as a resource for the department and provides leadership on complex issues. Advises and updates staff on procedural changes.
Acts as a resource to team members, which includes training/orienting, providing day-to-day work direction and creating staff schedule. Assigns, monitors, and reviews progress and accuracy of work, directs efforts, and provides technical guidance on more complex issues.
Assists with human resource responsibilities, which may include interviewing and selection of new employees, staff development, resolution of employee concerns, and employee morale.
Monitors and ensures adherence to regulatory and compliance standards, and that patient information is kept confidential. Assists management with the interpretation of department policies and procedures.
Gathers, processes, and records required information into the pharmacy system for record keeping, insurance verification and label generation purposes. Responsible for filling, maintaining, troubleshooting, and reporting functions of the database systems, programs, and equipment. Maintains drug files for billing and system-wide inventory control purposes.
Performs general housekeeping, medication recalls and returns, capital returns processing, and cashiering. Is a Role model in clinical support needs such as but not limited to DIR fees.
Performs limited insurance and third-party system wide billing functions for prescription claims. This includes data entry of customer demographics and third-party information, obtaining prior authorizations from appropriate third-party carriers, submitting third-party claims, maintaining files of prior authorization, investigating, troubleshooting, and correcting errors in submission to third parties and handling private insurance and other third-party insurance coverage and prescription-related issues.
Investigates delinquent accounts and other insurance issues by reviewing benefits, contacting insurance companies, as well as communicating with third-party administrators and occasionally customers. Reconciles all outstanding claims and third party rejects in a timely manner.
Processes new patient data entry and/or automatic refill in a timely manner. Performs inventory control, including ordering, stocking, and managing recalls and returns. Maintains adequate stock to meet the demand of the pharmacy.
Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures.

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Lead Pharmacy Technician

Lead Pharmacy Technician position overseeing technician staff, ensuring work acc...

Location

United States , Menomonee Falls

Salary:

25.30 - 37.95 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Licensure (IL only): State of Wisconsin (registration): Pharmacy Technician or Pharmacy Technician Student
Certification (CPhT) issued by PTCB or ExCPT within two years of hire, or sooner if required by law
Must sit for the certification exam at least one time within the first year of employment
Patient facing teammates may be required to have three certifications: Immunization, BLS through an entity approved by Advocate Health and non-vaccine injectable to be granted from the state of WI or if from out of state, the program is approved by the accreditation council for pharmacy education (ACPE) or by the WI pharmacy examining board
High School Graduate
Typically requires 3 years of experience in a pharmacy technician position that includes experience with third party insurance or Medicare within a retail environment
Demonstrated leadership skills such as delegation, team building, managing multiple priorities, problem solving, and decision making
Demonstrated knowledge of medication usage to appropriately identify the correctness of billing as well as appropriateness of medications for processing
Ability to understand and become knowledgeable of pharmacy standards, policies, procedures, and Health Insurance Portability and Accountability Act (HIPAA) regulations
Intermediate computer skills including the ability to navigate through a database and run reports

Job Responsibility

Oversees the activities of the pharmacy technician staff to ensure timely completion and accuracy of work
Acts as a resource for the department and provides leadership on complex issues
Advises and updates staff on procedural changes
Acts as a resource to team members, which includes training/orienting, providing day-to-day work direction and creating staff schedule
Assigns, monitors, and reviews progress and accuracy of work, directs efforts, and provides technical guidance on more complex issues
Assists with human resource responsibilities, which may include interviewing and selection of new employees, staff development, resolution of employee concerns, and employee morale
Monitors and ensures adherence to regulatory and compliance standards, and that patient information is kept confidential
Assists management with the interpretation of department policies and procedures
Gathers, processes, and records required information into the pharmacy system for record keeping, insurance verification and label generation purposes
Responsible for filling, maintaining, troubleshooting, and reporting functions of the database systems, programs, and equipment

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Claims Adjuster

A growing company in Warminster is seeking a Claims Adjuster for a long term eng...

Location

United States , Warminster

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 2 years of experience in a similar role as an Admissions Specialist
Proficiency in using ADP - Financial Services software
Experience with Avaya CMS
Knowledge and understanding of Banner Ads
Familiarity with CMS Platform
Ability to use various computer programs
Experience in answering inbound calls
Understanding and execution of benefit functions
Ability to perform billing functions efficiently
Experience in claim administration

Job Responsibility

Investigate, analyze, and resolve claims related to vehicle damage, customer property, and medium-to-high exposure third-party bodily injury
Assess claim value and liability to recommend settlements through denial, compromise, or payment
Ensure timely and accurate investigations, leveraging advanced techniques and knowledge of the insurance process
Apply specialized knowledge and techniques for understanding risks, insurance products, and claims investigation processes
Collaborate with other departments and stakeholders to understand risks under management and manage products offered
Handle complex and high-stakes claims requiring sound judgment and thorough analysis
Communicate effectively with claimants, legal representatives, and stakeholders to manage expectations and maintain professionalism
Address and resolve disputes or escalated issues on complex claims with diplomacy and tact
Explain policy details, coverage limitations, and claim decision rationale clearly and accurately
Ensure the integrity and security of proprietary information throughout claims handling

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Recovery Officer

At Allianz, we’re proud to be one of the world’s leading insurance and asset man...

Location

Australia , Sydney; Perth; Adelaide; Melbourne

Salary:

Not provided

Allianz

Expiration Date

Until further notice

Requirements

Experience in claims management within a complex, matrixed general insurance organization
Effective planning, prioritization, and task organization skills to manage competing demands and resources
High attention to detail, ensuring thorough and accurate completion of tasks, with a quick ability to spot errors or inconsistencies in information
Proficiency in technical aspects including systems, software, databases, reporting, and communication tools
Excellent verbal and written communication skills, adept at negotiation, and capable of balancing empathy and compassion with achieving optimal commercial outcomes for AAL

Job Responsibility

Engaging and negotiating successful debt recovery from Third Parties in a respectful manner, ensuring quality service to customers
Exceeding customer expectations with consistent positive experiences that build loyalty
Efficiently determining liability, negotiating debt repayment outcomes, and maximizing financial benefit for AAL
Responding promptly to customer needs, processing recovery claims accurately, and adhering to AAL phone standards
Demonstrating understanding and adherence to Financial Hardship requirements, including dealing with Customers Experiencing Vulnerability

What we offer

Be part of a team that’s open-minded, supportive, and genuinely focused on customer outcomes
A sense of belonging in the workplace, where you are welcomed and encouraged to bring your most authentic self to work
An employer that is committed to supporting your work/life balance and is always open to conversations about flexible & remote working
Access to over 10,000 on-demand learning resources and programs, to support you in taking control of your career development
Insurance products, deals and discounts across a great range of retail, tech, and travel brands, and offers for health and well-being
Initiatives to support your financial wellness through selected discounted Allianz insurance products, superannuation matching, salary sacrificing, novated leasing and our referral bonus scheme
The opportunity to take part in our Employee Share Purchase Program- own a piece of your employer

Fulltime

Claims Manager - Third Party Complex

Social Value Portal Ltd

Location:
United Kingdom , London

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
January 25, 2026

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