Claims Handler

Summary

Join IMG as a Health Claims Handler on a permanent contract working on a hybrid or remote basis with a competitive salary of £23,000 - £25,000 (Depending on Experience). This role involves assisting with the management of claims from first notification to payment, answering inbound correspondence, and interacting with insured members, medical providers, underwriters, and other third parties. As a Health Claims Handler, you will be responsible for processing claims accurately and efficiently within policy terms and conditions, determining insurance coverage and benefits available, investigating and resolving queries on new and previously adjudicated claims.

Requirements

• Experience of working within a healthcare setting, handling travel, medical or personal accident claims
• Experience of private medical insurance or international private medical insurance would be an advantage
• A high degree of accuracy and attention to detail with excellent numerical skills
• The ability to work well both independently and as part of a team
• The ability to follow processes and efficiently collect and process data in a friendly and professional manner
• Able to demonstrate good critical thinking and problem-solving skills
• Excellent written and verbal communication skills, understanding that all correspondence is remote, and many our insured members are not English mother-tongue
• A calm, diplomatic, open and professional approach, with the ability to handle enquiries from all parties, VIPs, insured members and underwriters alike
• PC skills with a good knowledge of Microsoft packages, ideally with advanced knowledge of MS Teams, Outlook, Word and Excel
• Able to demonstrate exceptional customer service in-line with our service expectations and goals

Responsibilities

• Always represent our clients and IMG in a professional manner and deliver a high degree of customer service to all insured members
• Review and adjudicate all claims to determine coverage within the policy terms and condition to ensure prompt decisions and settlement of eligible claims
• Adhere to all internal processes and procedures to ensure treatment received meets the policy requirements and accepted medical standards, and that all costs incurred are reasonable and customary
• Work closely with the Preauthorisation team and Medical team to monitor and update ongoing treatment plans for members and ensure that the underwriters are kept informed of a claim’s progress as required
• Assist with inbound calls in relation to claims, general policy queries and explanations of benefits where required. Notify the Preauthorisation team of any preauthorisation requests received
• All claims and correspondence must be answered promptly and within SLAs, providing the highest level of customer service at all times
• Be responsible for managing individual workload and productivity, ensuring daily feedback is provided to the management team. Notify the management team of any training and development needs
• Notify all complaints in a timely manner to management and the Quality Assurance team, and ensure all complaints are dealt with promptly and in line with the internal process and regulatory requirements
• Identify, notify and investigate any potentially fraudulent claims, legal threats or suspected data breaches in line with the internal processes and regulatory requirements
• Provide feedback to the management team and assist in the development of standard operating procedures and internal processes to ensure efficiency and a smooth customer journey
• Complete any further tasks deemed appropriate by your line manager and/or the Management Team

Benefits

• Hybrid / Fully Remote Working
• Competitive Salary of £23,000 - £25,000 (Depending on Experience)
• We promote internally as much as possible
• Diverse workforce
• Summer and Christmas Parties
• Birthday Day Off
• Bupa Dental Insurance
• Healthshield Cash Plan
• Travel Insurance
• 22 Days leave and 9 Bank Holidays, annual leave Increases to 30 Days
• Christmas Eve Off
• Surprise events for overachieving employees - such as tickets to Beyonce etc
• Employee of the month/year awards
• 2 volunteer days a year