Claims Assessor - Bristol, United Kingdom - Healix Group of Companies

Healix Group of Companies
Healix Group of Companies
Verified Company
Bristol, United Kingdom

2 weeks ago

Tom O´Connor

Posted by:

Tom O´Connor

beBee Recruiter
Description
Healix
  • Healix Health Services


  • Bristol


  • Bristol

Claims Assessor:


The Medical Claims Assessor is responsible for coordinating member treatment plans, you will be liaising with all members of the healthcare team and the member to ensure that all parties have the relevant information, and the member receives appropriate medical information and access to required medical services.


PERSON SPECIFICATION

  • We are looking for an individual with the following areas of expertise:A good understanding and previous experience of the private medical insurance industry and claims processing, would be an advantage.
  • Proactive in keeping up to date on all our clients' requirements and able to locate and interpret all relevant policy documentation.
  • High standard of customer service and ability to demonstrate customer led thinking.
  • Decision making skills and ability to use own initiative.
  • A diplomatic open style and approach, with excellent verbal and written communication.
  • A high degree of accuracy and attention to detail and work well under pressure.
  • The ability to work well both independently and as part of a team.
  • Good problem solving and analytical skills.
  • Good commercial awareness with the ability to make decisions with the "bigger picture" in mind.
  • Ability to make effective contact with clinicians, accurate assessment of information obtained and acting appropriately upon the outcome.
  • An overall external awareness of new technology or development within the industry to pre empt and be prepared for possible related queries.

Important Information

  • Location:
  • Healix Health Services


  • Bristol
, Three Temple Quay, Temple Back East, Bristol, England, City of Bristol, BS1 6DZ
  • Date Posted:


  • 31st October 2023

  • Closing Date:
  • 7th November 2023 Industry:
  • Healthcare
  • Job Type:
  • Full time
  • Salary:
  • From £26,000.00 Yearly to £30,000.

00 Yearly
About the role:

KEY ACTIVITES/MAIN DUTIESTake calls from clients, providers and specified members in relation to initial and/or ongoing claims.

  • Obtain medical evidence from providers to substantiate claims decision/treatment.
  • Deal with queries in relation to clinical treatment or pre authorisation requests.
  • Arrange care with the appropriate medical teaM/Facility.
  • Ensure treatment delivered is relevant and appropriate by monitoring ongoing treatment plans for members.
  • Negotiate provider fees within the Healix Reasonable and Customary fees, as part of cost containment for clients.
  • Ensure all documents are correctly and accurately allocated on Case Management System
  • Assisting the Case Managers with high cost claims where required.

What you will need

Required criteria

  • Do you have Customer Service Experience?
  • Do you have a good command of the English language?

Desired criteria

  • Do you have medical claims handling experience?

Healix:


All around the world, Healix safeguards people's health and wellbeing.
We offer UK employee healthcare benefits, and travel, medical and security assistance in every corner of the globe.

Our purpose is to help people in difficult situations - whether that's a cancer diagnosis, a need for medical assistance when they're far from home, or being caught up in conflict or natural disaster.

We talk to them, support them, and make sure they get the help they need. If necessary, we'll pull them out and bring them home.

We're co-ordinators and problem-solvers: experts at navigating the global health and security landscape.

Our teams of doctors, nurses, travel and medical co-ordinators and security experts make sure that your people will be looked after, whatever happens supported by technology designed help individuals, not slot them into a predetermined solution.

We work with governments, broadcasters, NGOs, international corporations, major insurers and more.

No two clients are the same:
we adapt our services to their needs.

More importantly, we adapt to the practical and human needs of the individuals we protect. Most of us are on the front line; we keep our back office lean. We don't use scripts, and we don't time calls. We never lose sight of the fact that we're dealing with real people.

Instead, we focus on ensuring our highly trained specialists have the space and time they need to be effective.

We let them use their initiative to get the job done, because the situations they face often throw up unexpected challenges - and no protocol survives contact with the real world.


Our clients have thousands of employees and customers, at home and abroad, so they need a business big enough to handle any situation.

But they chose Healix because they also need an organisation that's personal enough to care.

Our people are driven to do things in the best way, not the way they have always been done. We work hard, and our efforts are rewarded with great development opportunities and a supportive team spirit.
We want to nurture this friendly and dynamic company culture s
More jobs from Healix Group of Companies
See all jobs of Healix Group of Companies