Job Description

About us:

Our purpose is to help people lead healthier, happier, more productive lives and our people are key in achieving this. Our objective therefore is to create an environment where our people are empowered, motivated, strive for excellence & conduct themselves with integrity.

About the role:

Be the first point of contact for the business (1st line of defence) enabling the Society to be compliant in its day-to-day business Responsible for conducting Complaint and Fraud Investigations alongside associated Financial Crime processes, whilst adhering to regulatory requirements Maintain adequate records of the Society's complaint handling activities and Financial Crime/Fraud investigations in line with the rules of the Financial Conduct Authority (FCA) and the Prudential Regulatory Authority (PRA)

Main Responsibilities:

Liaise effectively via telephone, letter or email with members and other third parties when investigating level 1 & 2 complaints or providing a response to a complainant Gather relevant information to allow correct complaint decisions to be made Apply conduct risk principles to the resolution of complaints whilst maintaining consistency with normal Health Shield practice, and the reasonable expectations of the membership as a whole Digest and apply lessons learned from earlier investigations, and case studies published by the Financial Ombudsman Service Ensure that any redress or remedial action required as a result of a complaint investigation is properly administered Relay customer perceptions and comments, identify and analyse opportunities to improve processes, products and/or systems, providing recommendations and evidence to support proposed implementation Provide a professional and fair complaint resolution service to the members of the Society Gather relevant information to allow correct anti-fraud, know your customer or anti money laundering decisions to be made, with the advice of the MLRO where needed Contact members, medical practitioners and/or hospitals by email, telephone or post to determine whether the claim under investigation is valid Maintain confidentiality and exercise discretion throughout all investigations Assist in the development and implementation of checks and controls to prevent fraud or money laundering Apply conduct risk principles to the resolution of fraud outcomes, whilst maintaining consistency with normal Health Shield practice, and the reasonable expectations of the membership as a whole Digest and apply lessons learned from earlier investigations, and case studies published by the Financial Ombudsman Service Liaise with the HICFG and appropriate agencies in order to share information about fraud investigation and protect Health Shield from avoidable losses Support operational risk incidents relevant to the department and ensure correct closure and future prevention Assist members of the compliance and risk team to review and analyse existing processes and practices and help to identify regulatory compliance risks and solutions Ensure any assigned internal actions are closed within agreed timescales Contribute to the maintenance of relevant regulatory Complaints & Financial Crime policies and procedures Undertake any additional tasks as requested by the Operations Manager

Key Stakeholders:

All Internal Departments inc. Management and Leadership Team Members Practitioners/Vendors Financial Ombudsman (FOS) HM Police and other legal or regulatory institutions where necessary

About You

To be successful in this role you will need to have the following skills, knowledge & qualifications:

Experience working in financial services and a regulated business Experience of regulatory complaints processing through to level 2 Experience of financial crime prevention and operational fraud investigations Experience in supporting operational areas with regulatory compliance, including understanding a company's use of information technology Excellent organisational and time management skills Possess strong communication skills both written & verbal Well-organised, with a high attention to detail and ability to prioritise Possess a high level of confidentiality Strong analytical and problem-solving skills Computer & IT literate, knowledge of Microsoft applications Experience of regulatory complaints processing & liaison with the Financial Ombudsman Service Experience of Fraud Prevention controls, including the workflow relationship and approvals processes between the First Line of Defence and the Second Line of Defence

Code of Conduct Rules

Rule 1: You must act with integrity

Rule 2: You must act with due skill, care and diligence

Rule 3: You must be open and cooperative with the FCA, the PRA and other regulators

Rule 4: You must pay due regard to the interests of customers and treat them fairly

Rule 5: You must observe proper standards of market conduct

Rule 6: You must act to deliver good outcomes for retail customers

Our Values & Behaviours

Consistently role models our values & behaviours and actively encourage others to the same:

Customer Focused Straightforward Responsible Professional
Job Type: Full-time

Pay: 26,500.00 per year

Benefits:

Company pension Free parking On-site parking
Schedule:

8 hour shift Monday to Friday
Education:

GCSE or equivalent (preferred)
Experience:

Complaint handling: 1 year (preferred)
Licence/Certification:

Driving Licence (preferred)
Work Location: In person