Main Duties/Responsibilities:
- 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:
- Degree or diploma in a relevant field
- Customer focused with ability to identify and solve problems.
- Ability to meet/exceed targets and manage multiple priorities.
- Proficient in Microsoft Office applications.
- English and Arithmetic proficiency required.
- Experience in medical administration, claims environment or Contact Centre environment is advantageous.
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
- Ability to exercise judgement.