Claim Benefit Specialist
No Industry Experience Needed
- Paying GBP16,500.00 + Benefits + Performance Bonus
- FULL TRAINING GIVEN and FAST CAREER GROWTH
JOB TITLE: Claims Support Administrator
DEPARTMENT: Claims
JOB FUNCTION
To ensure smooth functioning of the claims administrative function integral to the Operations Team. To achieve all functions detailed below according to established procedures, while adhering to the highest standards, within the established turnaround times.
KEY RESPONSIBILITIES
• To load and process claims accurately as per the instructions of the Claims Executive.
• To communicate with the members about their claims accurately and effectively under the instructions of the Claims Executive.
• To receive all incoming claims through all sources; sort by established guidelines (includes date stamping, opening, bundling and counting) and acknowledge receipt accordingly.
• To route mail to other offices as necessary.
• To update dashboards with the daily count of incoming claims.
• To accurately log all incoming claims.
• To enter batch details as per stipulated procedures in the Claims batch log or post log, according to the type of claim.
• To track priority batches from identified premium providers.
• To flag all urgent claim submissions to the Claims Manager / Senior Claims Executive.
• To respond to any queries within the remit of their job function.
• To resolve any technical issues with the scanning or the post / batch logging of the claims within the boundaries of knowledge and escalate the issues to the Claims Manager / Senior Claims Executive in a proactive manner.
• To send and receive claims for translation as per stipulated procedures.
• To send Claims settlement letters (EOBs) to the claimants according to relevant procedures.
• To provide daily and weekly reports/logs as and when required by the Claims Manager / Senior Claims Executive, and ensure logs are updated and maintained regularly.
• Check for delayed claims submission from providers as per the contract agreements.
• Updating the Claims batch log as and when required so all the information about the batch is up to date.
• Assigning of payment entity to be used for data entry of the individual batches.
• Liaising with the vendors for claims count and payment entity related queries.
• Prioritizes workload and meets the expectations as per job description.
• To buddy up with lesser experienced staff and participate in training tasks as and when requested by the Claims Manager / Senior Claims Executive.
• Ensures compliance with requirements of regional compliance authority/industry regulator.
• Adheres to international privacy policies, practices and procedures and company standards.
• To promote the best image for the company through professional appearance and behaviours and to maintain the highest level of personal conduct.
EDUCATION & EXPERIENCE
It is essential that this individual has a good standard of education with excellent communication skills including letter writing skills and telephone manner.
Experience in an administration role/office environment is preferable.
The individual should also be computer literate and proficient in the use of the Microsoft Office suite.
PERSONAL CHARACTERISTICS
Should be adaptable and able to work on own with minimal supervision.
The role needs a high level of organisational skills and attention to detail is of importance.
Able to respond to team objectives
- Paying GBP16,500.00 + Benefits + Performance Bonus
- FULL TRAINING GIVEN and FAST CAREER GROWTH
JOB TITLE: Claims Support Administrator
DEPARTMENT: Claims
JOB FUNCTION
To ensure smooth functioning of the claims administrative function integral to the Operations Team. To achieve all functions detailed below according to established procedures, while adhering to the highest standards, within the established turnaround times.
KEY RESPONSIBILITIES
• To load and process claims accurately as per the instructions of the Claims Executive.
• To communicate with the members about their claims accurately and effectively under the instructions of the Claims Executive.
• To receive all incoming claims through all sources; sort by established guidelines (includes date stamping, opening, bundling and counting) and acknowledge receipt accordingly.
• To route mail to other offices as necessary.
• To update dashboards with the daily count of incoming claims.
• To accurately log all incoming claims.
• To enter batch details as per stipulated procedures in the Claims batch log or post log, according to the type of claim.
• To track priority batches from identified premium providers.
• To flag all urgent claim submissions to the Claims Manager / Senior Claims Executive.
• To respond to any queries within the remit of their job function.
• To resolve any technical issues with the scanning or the post / batch logging of the claims within the boundaries of knowledge and escalate the issues to the Claims Manager / Senior Claims Executive in a proactive manner.
• To send and receive claims for translation as per stipulated procedures.
• To send Claims settlement letters (EOBs) to the claimants according to relevant procedures.
• To provide daily and weekly reports/logs as and when required by the Claims Manager / Senior Claims Executive, and ensure logs are updated and maintained regularly.
• Check for delayed claims submission from providers as per the contract agreements.
• Updating the Claims batch log as and when required so all the information about the batch is up to date.
• Assigning of payment entity to be used for data entry of the individual batches.
• Liaising with the vendors for claims count and payment entity related queries.
• Prioritizes workload and meets the expectations as per job description.
• To buddy up with lesser experienced staff and participate in training tasks as and when requested by the Claims Manager / Senior Claims Executive.
• Ensures compliance with requirements of regional compliance authority/industry regulator.
• Adheres to international privacy policies, practices and procedures and company standards.
• To promote the best image for the company through professional appearance and behaviours and to maintain the highest level of personal conduct.
EDUCATION & EXPERIENCE
It is essential that this individual has a good standard of education with excellent communication skills including letter writing skills and telephone manner.
Experience in an administration role/office environment is preferable.
The individual should also be computer literate and proficient in the use of the Microsoft Office suite.
PERSONAL CHARACTERISTICS
Should be adaptable and able to work on own with minimal supervision.
The role needs a high level of organisational skills and attention to detail is of importance.
Able to respond to team objectives