Claims Officer

4 months ago


Newcastle upon Tyne, United Kingdom NHS Business Services Authority Full time

The Claims Officer role is an integral part of processing claims for the healthcare provided to eligible EEA and Swiss citizens in accordance with reciprocal healthcare agreements. You will be working as part of Overseas Healthcare Services within Citizen Services.

What do we offer?

27 days leave (increasing with length of service) plus 8 bank holidays

Flexible working (we are happy to discuss options such as compressed hours)

Flexi time

Hybrid working model

Career development

Active wellbeing and inclusion networks

Excellent pension

NHS Car lease scheme

Access to a wide range of benefits and high street discounts

Working as part of a team, the Claims Officer will use their analytical skills to review and assess finance data and records submitted by healthcare facilities, EEA member states and Switzerland in order to process the claims for reimbursement in accordance with agreed procedures, policy and technical instructions.

A key element of the role involves working with internal and external stakeholders and customers; therefore, the Claims Officer will need a high level of communication and customer service skills to approach this role effectively. The Claims Officer will use existing and newly developed communication and case management systems and should be comfortable in adapting to regular changes to processes and improvements to technology.

The interview will be a face to face interview.

Here at the NHS Business Services Authority (NHSBSA), what we do matters.

We manage the NHS Pension scheme, process prescription payments and much more. Our services are used by NHS organisations, contractors and the public: we take pride in being part of something so meaningful, that touches millions of lives.

Just as we design our services around the needs of our customers, we place our people at the heart of our organisation. That’s why when you join us, you’ll be empowered and given the right support to help your career grow.

As one of the UK’s Best Big Companies to work for, we’re all connected to our values: Collaborative, Adventurous, Reliable and Energetic. We care about our people, our purpose, and your progress.

We strive to offer a fantastic colleague experience, where every voice is heard, and every colleague is supported and respected. Wellbeing, diversity and inclusion is at the centre of this, so when you join us, you can connect with our Lived Experience Networks who help us to bring our authentic selves to work.

We are people connected to care.

**In this role, you are accountable for**:
Ensuring all claims processing is carried out in accordance with Governance frameworks, policies and procedures ensuring that accurate and auditable records of activities are maintained.

Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.

Self-managing and planning your own daily workloads to ensure optimally effective outputs. Operating all services in line with Service Level Agreements, internal agreements/ policies within agreed time scales and ensuring all personal copies of standard operating procedures are up to date.

Collating and interpreting information obtained from business records, other business areas and stakeholders.

Understanding/interpreting regulations and analysing data to enable well informed evidence based decisions to be made. Communicating with DHSC policy team to deal with exceptional cases when necessary and escalating cases to the Service Delivery Manager when appropriate.

Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures.

Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions.

Communicating effectively with customers and internal/external stakeholders, resolving and answering enquiries on own initiative to provide an excellent level of written and verbal customer service.

Dealing with all situations encountered in a professional and productive manner.

Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required.

Ensuring your objectives are developed and owned that in turn fully support the service objectives.

Working to agreed internal performance and accuracy targets. Agreeing realistic personal targets, monitoring and evaluating own achievements, with timely and constructive feedback.

Working in an organised manner and complying with office systems in place to ensure that paperwork relating to individual and member states claims is kept together and can be easily and quickly retrieved.

Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues.

Undertaking any other duties and responsibilities as agreed with your line manager and commensurate wit


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