Customer Service Advisor

7 months ago

Bristol, United Kingdom Healix Full time

Are you looking for a rewarding career in the private medical industry? Do you have excellent customer service skills and a passion for helping people? If so, you might be the perfect fit for our Medical Claims Assessor role

As a Medical Claims Assessor, you will be responsible for coordinating member treatment plans, liaising with all members of the healthcare team and the member, and ensuring that the member receives appropriate medical information and access to required medical services. This is a role where good Customer Service skills are key, and you are not required to have any medical qualifications.

**YOU WILL BE INVOLVED IN**:

- Taking calls from clients, providers and specified members in relation to initial and/or ongoing claims
- Obtaining medical evidence from providers to substantiate claims decision/treatment
- Dealing with queries in relation to clinical treatment or pre-authorisation requests
- Arranging care with the appropriate medical teaM/Facility
- Ensuring treatment delivered is relevant and appropriate by monitoring ongoing treatment plans for members
- Negotiating provider fees within the Healix Reasonable and Customary fees, as part of cost containment for clients
- Ensuring all documents are correctly and accurately allocated on Case Management System
- Assisting the Case Managers with high cost claims where required

**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.

**About The Role**

**About Healix**

Healix is a leading provider of global medical assistance and healthcare solutions. We have a large and varied client base which includes multinational corporations, travel insurance companies, charities, airlines, government and military departments.

**What we offer**

We offer welcoming, friendly and supportive working environment. At Healix, we truly believe that 'our people’ are at the heart of our success; employees are treated with dignity and respect and are always encouraged to reach their full potential.
- 'I enjoy working at Healix as we are small enough for everyone to know each other and big enough to meet my career aspirations; There are plenty of opportunities for development’_ Luke, joined in 2018

**Company Benefits include**
- Competitive annual salary
- 5 weeks annual leave (or equivalent in hours) in addition to public holidays
- Pension scheme
- Healix Group Healthcare
- 4 times Life Assurance

The Healix culture is warm and friendly, we are proud of our working environment and our loyal and dedicated employees.

**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?

**Skills Needed**

**About The Company**

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 o

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