Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
Monitor and highlight high cost claims and ensure relevant parties are aware.
Monitor turn around times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable.
Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.
Interface effectively with internal and external customers to resolve customer issues.
Identify potential process improvements and make recommendations to team senior.
Actively support other team members and provide resource to enable all team goals to be achieved.
Work across European business in line with service needs.
Carry out other adhoc tasks as required meeting business needs.
Experience Required:
At least 1 year of experience in a claims role within a healthcare, insurance, or related environment.
Customer focused with ability to identify and solve problems.
Ability to meet/exceed targets and manage multiple priorities.
Proficient in Microsoft Office applications.
Demonstrated proficiency in mathematics, with strong attention to detail and accuracy when handling calculations and numerical information.
Skills:
Must possess excellent attention to detail, with a high level of accuracy.
Strong interpersonal skills with good verbal and written communication to internal and external clients.
Strong customer focus with ability to identify and solve problems.
Ability to work under own initiative and proactive in recommending and implementing process improvements.
Ability to organise, prioritise and manage workflow to meet individual and team requirements