Claims Resolution Specialist

3 days ago


Cardiff, Cardiff, United Kingdom International Medical Group Full time

Job Description: Claims Resolution Specialist

As a Claims Resolution Specialist at International Medical Group, you will play a critical role in ensuring that claims are processed efficiently and accurately. You will work closely with our Preauthorization and Medical teams to monitor and update ongoing treatment plans.

Key Responsibilities:

  • Represent clients and deliver high customer service to all insured members.
  • Review and adjudicate claims to determine coverage within policy terms and conditions.
  • Adhere to internal processes and procedures to ensure treatment meets policy requirements and accepted medical standards.
  • Work closely with Preauthorization and Medical teams to monitor and update ongoing treatment plans.
  • Answer inbound calls in relation to claims, general policy queries, and explanations of benefits.

Requirements:

  • Experience in a healthcare setting, handling travel, medical, or personal accident claims.
  • Private medical insurance or international private medical insurance experience is an advantage.
  • Ability to follow processes and collect and process data in a friendly and professional manner.
  • Excellent written and verbal communication skills, understanding remote correspondence and non-English speaking members.
  • PC skills with a good knowledge of Microsoft packages, ideally with advanced knowledge of MS Teams, Outlook, Word, and Excel.

Benefits:

  • Competitive Salary of £23,000 - £25,000 (Depending on Experience)
  • Hybrid / Fully Remote Working
  • Bupa dental insurance, healthshield cash plan, travel insurance, 22 days leave, and 9 bank holidays.

Estimated Salary Range: £23,000 - £25,000 per annum based on the UK location.



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