Claims Assessor - Bupa Egypt Insurance
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 Supervisory 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
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 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 firstname.lastname@example.org, so we can make adjustments accordingly.