Claims Assessor (Shift Basis)
To take responsibility for entire claims assessment process including benefit explanation.
This role is a shift basis role, you will be asked to work based on hours and/or days shift.
- 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.
- Recognize 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
- 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
We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.
Bupa’s purpose is longer, healthier, happier lives and making a better world.
Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives.
Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, anywhere in the world, whether at home or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Dubai (UAE, in partnership with OIC), and Hong Kong (China) as well as regional offices in mainland China, Singapore, Egypt, Mexico, the Dominican Republic, Bolivia, Brazil, Panama, Guatemala and Ecuador.
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.