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Health Claims Advisor - Cardiff Bay

Contract:
Permanent
Category:
Full Time
Job Sector:
Administration / Office Work, Customer Service, Financial Services / Insurance, Contact Centre
Region:
South Wales
Location:
Cardiff
Salary description:
£16, 450/ annum
Posted:
30/05/2019
Start Date:
ASAP
Recruiter:
Global Response Ltd
Job Ref:
HCA0519

Health Claims Advisor

Cardiff 

Full Time

Health Team

Entry Level

Global Response provides medical assistance and claims handling services to travel and medical insurance policy holders and corporate clients across the globe.  With an experienced, multi-lingual team, in-house medical staff and a superb reputation within the insurance industry, Global Response’s award winning service ensures that policyholders and employees get the best possible care, whatever the situation and wherever they are.

Global Response is looking for a Health Claims Advisor to join our team!

Working in liaison with the Pre-Authorisation Administrators and the entire Health Services team, the Health Claims Advisor will provide administrative and customer service support to our insured members at all times.

Responsibilities:

  • Support Pre-Authorisation Administrators and Claims Handlers in dealing with member requests from referral through discharge, including issuing pre-authorisation of eligible claims
  • Answer incoming calls quickly and within agreed service standards, providing a high level of customer service at all times.
  • Deal with provider queries or requests in relation to clinical treatment or pre-authorisation requests
  • Request relevant information Pre-authorisation Administrators may require to make cover decisions
  • Process invoices received in line with agreed service standards, issue pre-authorisation or Guarantees of Payment withinmember benefit limits or policy terms and conditions as directed by experienced or senior team members
  • Once signed off, issue pre-authorisation in line with agreed authority level with escalation to the relevant senior member of the team or Manager
  • Assist Pre-authorisation Administrators in the management of ongoing or high costs claims
  • Manage Claims administration Tasks and outstanding actions as appropriate
  • Assess invoices received to ensure charges are in line with provider contract terms
  • Adhere to all internal processes and procedures at all times
  • Maintain and document accurate records of all invoice or claim related payments on Trident Health and in communications with members or providers
  • Where relevant audit all provider invoices in line with Reasonable & customary rates or in line with GOP issued
  • Escalate any call-backs in a timely manner
  • Communicate directly with members, clients, providers and other members of Global Response or IMG Group as may be required.

Relevant skills

  • Health Claims Advisors are required to have or develop all the following areas of expertise:
  • Strong customer focus with excellent  verbal and written communication skills
  • Positive helpful attitude and willing to work cooperatively with other members of the team
  • A basic understanding and previous experience of the medical insurance industry and claims processing, an advantage.
  • PC skills with good knowledge of Microsoft packages.
  • The ability to demonstrate customer led thinking.
  • Highly adaptable and with a flexible approach to work and be willing to do what is required to ensure that team achieves its objectives while remaining focused on quality
  • Proactive approach to work and analytical problem solving skills.
  • The ability to plan and organise own workload, and work well under pressure.
  • The ability to work well both independently and as part of a team.

To ensure delivery of exceptional customer service within the department, we have service expectations and goals.

All team members will be monitored for level of efficiency, accuracy and customer satisfaction

Full training will be provided

Hours:

  • This team works 35 hours a week between the hours of 8am and 8pm with two main shift patterns (8am-4pm or 12noon - 8pm).  This may include weekends and bank holidays.  

Salary:

  • £16,450/annum

Global Response is committed to developing and maintaining working environments and practices, which ensure equality of opportunity in both the recruitment and advancement of staff.  Global Response works on behalf of FCA Regulated Companies and will therefore carry out background checks.

To apply for this role, please submit your details online by clicking here or the Apply Now button below.

Company Description

Global Response is an award-winning leader in travel medical assistance and claims management.

Established in 1998, Global Response has developed best-in-class operations, systems design and structure, cost containment and management, and fraud identification.

Underpinned by an extensive, worldwide agent network, Global Response is truly an international player in the market. With a multilingual customer support team, Global Response is capable of handling cases in any country 24 hours a day, 7 days a week, 365 days a year.

Global Response is an integral subsidiary of International Medical Group® (IMG®), a leader in global benefits and assistance services for more than 25 years.”

Closing Date:
05/06/2019

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