Claims Associate Rep

Roles and Responsibilities :

Main Duties/Responsibilities:

• Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
• Monitor and highlight high cost claims and ensure relevant parties are aware.
• Monitor turn around times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable.
• Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.
• Interface effectively with internal and external customers to resolve customer issues.
• Identify potential process improvements and make recommendations to team senior.
• Actively support other team members and provide resource to enable all team goals to be achieved.
• Work across European business in line with service needs.
• Carry out other adhoc tasks as required meeting business needs.

Experience Required:

• Customer focused with ability to identify and solve problems.
• Ability to meet/exceed targets and manage multiple priorities.
• Proficient in Microsoft Office applications.
• Preferred if English and Arithmetic qualification gained.
• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential.

Skills:

• Must possess excellent attention to detail, with a high level of accuracy.
• Strong interpersonal skills with good verbal and written communication to internal and external clients.
• Strong customer focus with ability to identify and solve problems.
• Ability to work under own initiative and proactive in recommending and implementing process improvements.
• Ability to organize, prioritize and manage workflow to meet individual and team requirements
• Ability to exercise judgment.