Claims Assessor

6 months ago

Bristol, United Kingdom Healix Full time

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.

**About The Role**

**KEY ACTIVITES/MAIN DUTIES**
- Take 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.

**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 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.

**Company Culture**

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 so that we can continue to attract diverse talent with a breadth of knowledge and world-class skills. As a part of Healix, you can expect a range of excellent benefits and an environment where people really do care.

**Company Benefits**

Commitment to career development

We are committed to helping our people build and develop successful careers. Our employees are given direct responsibility and opportunity to develop and grow whilst w

  • Senior Claims Assessor

    6 months ago

    Bristol, United Kingdom Diligenta Full time

    **Who are Diligenta?** Our vision is to be acknowledged as Best in-class Platform based Life and Pensions Administration Service provider. Customer service is at the heart of everything we do, and our aim is to transform our clients' operations. A business that has been described as ‘home’ by existing employees, we drive a culture that is founded on...

  • Pet Claims Assessor

    6 months ago

    Bristol, United Kingdom Vermelo RPO Full time

    Are you an experienced Registered Veterinary Nurse or Pet Claims Assessor looking for you new adventure? My client is looking for eager individuals to come join their team, working 8am - 4pm Monday - Friday the role is FULLY REMOTE! You will be assessing new and continuous claim submissions by reviewing all documentation supplied, ensuring prompt and...

  • Life Claims Assessor

    6 months ago

    Bristol, United Kingdom Aviva Full time

    Life Claims Assessor Salary £34,000 - £40,000+ Aviva paid more than 50,000 individual protection claims last year to a value of over £1 billion. To help us continue to deliver on our promises, we’re looking for Senior/Experienced Life Claims Assessors who are ready to be part of our amazing team that settles 98.3% of all individual protection...

  • Life Claims Assessor

    6 months ago

    Bristol, United Kingdom Aviva Full time

    **Life Claims Assessor** **Salary £34,000 - £40,000+** Aviva paid more than 50,000 individual protection claims last year to a value of over £1 billion. To help us continue to deliver on our promises, we're looking for Senior/Experienced Life Claims Assessors who are ready to be part of our amazing team that settles 98.3% of all individual protection...

  • Life Claims Assessor

    6 months ago

    Bristol, United Kingdom Aviva Full time

    Life Claims Assessor - Salary £34,000 - £40,000+- Aviva paid more than 50,000 individual protection claims last year to a value of over £1 billion. To help us continue to deliver on our promises, we’re looking for Senior/Experienced Life Claims Assessors who are ready to be part of our amazing team that settles 98.3% of all individual protection...

  • Clinical Claims Assessor

    5 months ago

    Bristol, United Kingdom Irish Life Full time

    **Location**:Bristol, GB**Company**:CLFIS Limited**Description: - Canada Life UK looks after the retirement, investment and protection needs of individuals, families and companies. We help to build better futures for our customers, our intermediaries and our employees by operating as a modern, agile and welcoming organisation.- Part of our parent company...

  • Clinical Claims Assessor

    5 months ago

    Bristol, United Kingdom Canada Life Full time

    Canada Life UK looks after the retirement, investment and protection needs of individuals, families and companies. We help to build better futures for our customers, our intermediaries and our employees by operating as a modern, agile and welcoming organisation. Part of our parent company Great-West Lifeco, Canada Life UK has operated in the United Kingdom...

  • Clinical Claims Assessor

    6 months ago

    Bristol, United Kingdom Canada Life Full time

    Canada Life UK looks after the retirement, investment and protection needs of individuals, families and companies. We help to build better futures for our customers, our intermediaries and our employees by operating as a modern, agile and welcoming organisation. Part of our parent company Great-West Lifeco, Canada Life UK has operated in the United Kingdom...

  • Team Leader Medical Claims Assessor

    6 months ago

    Bristol, United Kingdom Healix Full time

    We are looking for an experienced Medical Claims Assessor who is ready to take the next step into leading and motivating the Medical Claims Assessor team in Esher. Working in liaison with and reporting to direct report, the Team Leader will be responsible for: Leading and inspiring team members to deliver outstanding service to both internal and external...

  • Technical Claims Handler

    5 days ago

    Bristol, United Kingdom CV-Library Full time

    Are you an experienced claims handler with an indemnity background looking for a new position within a legal firm? Our client is an international law firm with offices in the UK, Hong Kong and Singapore who are committed to having trusted relationships, having an inclusive culture and being natural advocates for their clients. They are looking for...

  • Technical Claims Handler

    12 hours ago

    Bristol, United Kingdom Red Recruitment Full time

    Are you an experienced claims handler with an indemnity background looking for a new position within a legal firm? Our client is an international law firm with offices in the UK, Hong Kong and Singapore who are committed to having trusted relationships, having an inclusive culture and being natural advocates for their clients. They are looking for...

  • Senior Nuclear Safety Assessor

    1 month ago

    Bristol, United Kingdom CV-Library Full time

    Our client is a large consultancy, who work internationally in several different sectors. They are part of a large multinational consultancy group and work across built environment and ecological projects. In the UK they are currently looking for a Safety Assessor for their Nuclear Division that works on several projects in the UK on new build &...

  • Vehicle Damage Assessor/estimator

    5 months ago

    Bristol, United Kingdom Halo ARC Full time

    Job Advert **Vehicle Damage Assessor / Estimator** **Salary: £35,000-£40,000 per annum.** **Hours: 8.00am - 5.00pm Monday to Friday, potential overtime depending on business needs.** **Halo ARC Bristol** Halo is the industry leading UK-based accident repair group, with **32** established accident repair centres **across the UK and we are** still...

  • Vehicle Damage Assessor/estimator

    6 months ago

    Bristol, United Kingdom Halo ARC Full time

    Job Advert **Vehicle Damage Assessor / Estimator** **Salary: £35,000-£40,000 per annum** **Hours: 8.00am - 5.00pm Monday to Friday, potential overtime depending on business needs.** **Location: Halo ARC Bristol** Halo is the industry leading UK-based accident repair group, with **30** established accident repair centres **across the UK and we are**...

  • Benefits Officer

    5 months ago

    Bristol, United Kingdom GCS Recruitment Specialists Ltd Full time

    Are you a dedicated individual looking to make a difference in your community? Bristol City Council is seeking a Benefits Assessor to join our dynamic team. If you have a passion for delivering exceptional service and making a positive impact, we want to hear from you. **Job Details**: **Job Title**: Benefits Assessor **Grade**: BG8 **Managed by**:...

  • Clinical Claims Assessor

    6 months ago

    Bristol, United Kingdom Canada Life Group (UK) Ltd (The) Full time

    Canada Life UK looks after the retirement, investment and protection needs of individuals, families and companies. We help to build better futures for our customers, our intermediaries and our employees by operating as a modern, agile and welcoming organisation.Part of our parent company Great-West Lifeco, Canada Life UK has operated in the United Kingdom...

  • Apprentice Parts Advisor

    6 months ago

    Bristol, United Kingdom Wessex Garages Full time

    Reference Number - 0123445567567 - Location Cribbs Causeway, Bristol- Salary NMW Apprentice schemeWe are recruiting an Apprentice Parts Advisor. A Parts Advisor is a key member of the team is responsible for the smooth running of the parts department, supporting the efficient effective supply of parts to the workshop. A Parts Advisor: - Is responsible for...

  • Customer Service Advisor

    6 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...

  • Customer Service Advisor

    6 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...

  • Apprentice Parts Advisor

    6 months ago

    Bristol, United Kingdom Wessex Garages Full time

    We are recruiting an Apprentice Parts Advisor. A Parts Advisor is a key member of the team is responsible for the smooth running of the parts department, supporting the efficient effective supply of parts to the workshop. A Parts Advisor: - Is responsible for ordering, selling and managing stock control on vehicle parts. - Communicates effectively with...