Claims Management Consultant- BG EEA
Ensure an exceptional customer experience for our customers by swiftly and accurately resolving all customer claims queries. Customer contact will be across all communication channels – phone, email, web chat and letter.
This is a diverse and skilled customer facing role where you will be responsible for resolving all claims queries to the customer’s complete satisfaction without the need to refer the customer on. This will include assessing complex and high value claims from all customer groups – Individual, SME and Corporate customers, and Intermediaries.
Your individual performance will be a key contribution to the department achieving all targets for quality, productivity, compliance and regulation.
You will be a claims subject matter expert, putting the customer at the centre of everything you do and using your claims knowledge to put forward ideas for the continual improvement of the customer experience.
- End-to-End ownership to ensure claims are resolved
- Taking end to end ownership for the resolution of all customer claims enquiries. Case manage all queries through to resolution.
- All case handling, including Complex Cases
- Responsible for complex case handling i.e. large claim authorization, extraordinary benefits and ex-gratia payments.
- Achieving all targets for contact handling, turnaround times and quality.
- Customer Records
- Support Manager and act as a” Stand-in” on administrative tasks as and when required.
- Accurately maintaining and updating customer records on the customer management system. Ensure that records are accurately updated.
- Fraud Detection
- Help identify and prevent acts of fraud on IPMI claims,
- Report and monitor any fraud activity, providing monthly MI where possible
- Ensure that activities and processes are implemented to prevent future fraudulent activity.
- Claims Project (as required)
- Participate in projects demanding decision making and high level of responsibility within operations and/or cross-departmental.
- Relationship Building
- Travel when required on operational visits to Partners
- Build effective relationship with teams delivering EEA Customers claims process (e.g. Brighton UK service team; Genpact as required)
- Relationship building, close cooperation to provide follow up on reporting, claims queries, working processes via conference calls or e-mails.
- Work positively together with other teams and departments, treating them as internal customers and not creating barriers between departments.
- Policies and Procedures for BGEEA Claims team
- Together with claims manager, responsible for claims-procedures in the team.
- Implement streamlined processes and procedures and provide business support on all claims aspects within your team and your department.
- Team work and collaboration
- Ensure the Claims management team of BGEEA is working together, and seamlessly for the customers.
- Support and coach colleagues as required, including flexibility around role demands and team priorities.
- Culture and Conduct
- As part of the BG DAC business ensure that you live the Bupa values and a role model for conduct standards for colleagues
- Drive a culture of continuous improvement that constantly seeks to improve customer outcomes, eliminate waste and increase efficiency and productivity in your area of responsibility
Being a Customer Service Champion within Claims. Contribute to the continuous improvement process by challenging exiting process and contributing ideas for improvement
The Ideal Candidate
About the Company
Bupa’s purpose is longer, healthier, happier lives.
As a leading global health and care company, we offer health insurance, medical subscription and other health and care funding products; we run care homes, retirement and care villages, primary care, diagnostic and wellness centres, hospitals and dental clinics. We also provide workplace health services, home healthcare, health assessments and long-term condition management services. We have 32M customers globally. With no shareholders, we invest our profits to provide more and better healthcare and fulfil our purpose. We employ 86,000 people, principally in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India, and the USA.
We have grown significantly, particularly through 2013 to 2015, when we accelerated execution of our strategic vision. We are similar in revenue and profit to Marks & Spencer, and larger than Heinz in revenue. Because Bupa does not have shareholders it does not have a listing, but if it did it would be in the FTSE 100. Bupa is not a mutual or a charity but a company limited by guarantee that seeks to maximise its profits in order to fulfil its purpose. With customers in virtually every country in the world and 70% of its revenues now generated outside the UK, Bupa is a truly international organisation.
Bupa's Strategic Framework
Our strategy has three pillars: Customers, People, Performance. It puts our customers front and centre in the context of today’s digital age. As a service organisation, everything we do for our customers relies on our people and partners, so being a place where people love to work is critical to our success. This, combined with disciplined risk and capital management, is how we will deliver strong and sustainable performance.
We are looking for individuals who share in our values and this strategy, and are capable of delivering outstanding results for the business.
Bupa’s International Markets (IM) unit has 16 million customers across all continents around the world. It manages a portfolio of businesses, including a large international health insurance, travel insurance and medical assistance business called Bupa Global, as well as established domestic health insurance businesses in Hong Kong and Brazil, two associate health insurance companies in Saudi Arabia (34.25% Bupa ownership) and India (49% Bupa ownership), and Hong Kong’s largest private clinic network.
Bupa Global provides products and services worldwide to people who want access to premium health and care at home or as they study, live, travel or work abroad. We provide international health insurance, travel insurance and medical assistance to individuals, small businesses and global corporate customers all around the world.
Bupa Global has over 1,800 employees and has offices in London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Hong Kong (Greater China), and Dubai (UAE), as well as in Egypt, Mexico, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador. Bupa Global is currently organised around five regional hubs: Bupa Global Africa, India & Middle East; Bupa Global Greater China; Bupa Global Latin America; Bupa Global North America and Bupa Global Europe.
Timescales for reviewing applications will differ between regions, but you will always receive a response to your application. The recruitment process itself will vary per role and region, but you will be updated along the way via phone and email (so please look out for these!). To view what stage of the process your application is currently at, you can also log in and view your dashboard.
If you are invited to an interview, a member of the resourcing team will be able to advise you on what to expect. This will vary in region, but will likely include an initial phone or digital interview, followed by one or more of the following depending on the role: Core capability interview; Technical/function specific interview; Online profiling assessment; Presentation, written task, role play; Assessment centre.
If your application is successful and you’re invited to join the team, the resourcing team will guide you through your on boarding journey.
Should you require any reasonable adjustments to be made or facilities provided to enable you to attend an interview, please do not hesitate to contact us prior to the interview at email@example.com, so we can make adjustments accordingly.