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Claims Officer
2 weeks ago
In this role, you are accountable for 1. 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. 2. Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.
3. 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. 4.
Collating and interpreting information obtained from business records, other business areas and stakeholders. 5. 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.6.
Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures. 7. Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions. 8.
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. 9. Dealing with all situations encountered in a professional and productive manner. 10.
Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required. 11. Ensuring your objectives are developed and owned that in turn fully support the service objectives. 12.
Working to agreed internal performance and accuracy targets. Agreeing realistic personal targets, monitoring and evaluating own achievements, with timely and constructive feedback. 13. 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.
14. Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues. 15. Undertaking any other duties and responsibilities as agreed with your line manager and commensurate with your role.
