Claims Assessor - Bupa Egypt Insurance 3 Months Temp
To take responsibility for entire claims assessment process including benefit explanation.
- Inputting claims into the computer system with a high degree of accuracy.
- To action any claim related query in line with Bupa Global policy and style.
- To obtain all necessary information on claims for the purpose of complete processing, including liaison with internal departments, using the following methods: telephone or e-mail. This may also include gaining information to research further details required to assess a claim.
- Respond to all relevant incoming correspondence and queries from our internal departments. This will be as per the Claims department key performance indicators, which state turnaround time and quality standards.
- Ensure the correct interpretation of BUPA Internationals’ policy and rules, using the correct compatible combinations of codes for accurate processing of data, in accordance with our service standards and customer expectations.
- To provide excellent customer service for our members as stated in our aims and mission statement. The job holder will need to make customer focused actions based on effective decision making skills. This will also include excellent internal customer service, with continuous contribution given towards achieving individual, team and department goals and objectives.
- To contribute to the continuous development of the claims process by identifying opportunities for product development and process improvement.
- Suspend claims that require further investigation in order to resolve appropriately to ensure the correct continuation of processing within agreed timeframes and standards in suspend process.
- Logging claims on the system under correct members’ registrations, when needed.
- Translate Arabic documents to English when requested by other Bupa International departments.
- Recognise and challenge possible fraudulent information and proactively seek to clarify and resolve using best method of communication and initiative.
- To comply with and abide by the requirements of the Egyptian Financial Regulatory Authority at all times
- Work on shift basis according to business need.
The Ideal Candidate
- The jobholder should be educated to degree level or equivalent
- The jobholder should have a medical background
- The jobholder must be fluent in written and spoken Arabic & English
- Experience in a position with a medical background is desirable
- Background in the global health insurance market, or relevant transferable skills and knowledge from other financial services industries such as Life Insurance, Retail, Commercial or Investment Banking and Wealth Management
- A track record of achieving and exceeding productivity and quality targets
- Highly customer focused
- Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
- A third language other than English and Arabic is an advantage.
- Good keyboard and IT skills - Interpret written data and translate to the appropriate codes to be accurately input onto the in house computer system
- Numerate - Be able to understand numerate information presented on invoices from providers and be able to perform calculations to ensure the accuracy of the claims information
- Good problem solving and prioritisation skills, with close attention to detail
- Ability to work to targets under pressure
- Ability to work well alone, as well as part of a Team
- A knowledge of worldwide currencies and geographical locations is desirable