Claims Assessor

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To ensure that valid claims are processed quickly and accurately to achieve KPI. To provide clerical and administrative support. To deliver a service to the member in line with Health Shield’s Treating Customers Fairly Conduct of Business Principles and business objectives. To represent Health Shield in a professional manner at all times.

Principle Accountabilities

  • Ensure that correct payments are made on eligible claims and provide a full explanation when payment has been declined in line with Company and regulatory requirements
  • Pass possible fraudulent or incomplete claims to the Verifiers for confirmation
  • Input and update of bank details and personal information on member records
  • Data entry input of claims and checking
  • Respond to members claims queries and correctly log interactions

When required:

  • Create benefit payments and corresponding reports
  • Send letter to member where a BACS claims payment sent via email has bounced back
  • Create/amend benefit tables on the Navision system to ensure that correct benefits are paid
  • Deal with claims where there has been an alteration in membership status
  • Do code changes and balances when an incorrect payment has been paid to a member
  • Obtain secondary confirmation from Hospitals where needed
  • Assist other Claims staff as required
  • Any ad hoc tasks requested by your Manager/Team Leader/Senior

Contact with Others

Internal: Contact with all departments

External (as required):

  • Members
  • Hospitals
  • Health Practitioners
  • Medical Advisor

Education, Skill and Knowledge Required

  • Friendly, professional and excellent telephone manner
  • Strong team player
  • GCSE (or equivalent) grade C or above in English and Maths
  • Experience of data input & procedures
  • Time management – ability to handle multiple priorities, organise work and meet deadlines
  • Strong customer service and communication skills
  • Self-motivated and able to use own initiative
  • Knowledge of Microsoft office applications
  • Experience of working in a regulated environment an advantage
  • Strong administrative and organisational skills

Work arrangements: Full time, Monday – Friday 37.5 hours per week.

Benefits:

  • Competitive salary
  • Free car parking
  • Free electric hook up for electric cars
  • Corporate membership of the Health Shield medical cash plan after completion of probation (6 months)
  • 25 days annual leave plus bank holidays
  • Free on site gym
  • Free refreshments (tea, coffee, juice etc.)
  • Training and development support
  • Wellbeing initiatives
  • Quarterly on site wellbeing therapy treatments
  • Employee development scheme – staff can get a contribution towards non work related personal development activities
  • Salary sacrifice schemes

If you are interested in applying for this post please download an application form or request one by emailing: careers@healthshield.co.uk or by telephoning (01270) 503963.

We are an equal opportunities employer and welcome applicants from all sections of the community.