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Claims Assessor
This job has expired, and cannot be applied for.
- Posted By: Matched Ltd
- Address:
- Contact: 01252 713 377
- Date Posted: 17th Oct 2008
- Salary: c£20,000
- Location: Farnham
- Reference Code: 4/79
- Views Since Posting: 85
- Full Description:
To assist with the efficient running of the claims department.
Advise Co-ordinators on cases that should be referred and case manage any claims which do not require such a referral.
To accurately assess and manage medical claims received and to settle them in accordance to liability.
To resolve any technical or contentious claims within the boundaries of medical knowledge and policy held.
To liaise with any internal or external people to discuss medical conditions. To continually strive to improve and develop medical knowledge.
To liaise with Underwriters and placing brokers about policies and decisions in the absence of the Medical Claims Supervisor.
Accurately cost contain and audit treatment bills before settling medical claims.
To negotiate reductions and set charges with hospitals and other service providers and to have a market awareness of prices and costs within the private medical environment across the board.
To fully investigate all information that is received concerning claims and to query any anomalies that may occur.
To communicate all decisions to the insured effectively and accurately and to retain copies of correspondence sent, on file.
To ensure that all computer records are up-to date and accurate.
To maintain filing system so that records can easily be found.
To take ownership of and responsibility for customer enquiries politely and efficiently on the telephone.
All claims forms to be dispatched on the day of receipt of request.
All postal correspondence to be prioritised and actioned within 14 working days of receipt.
Email queries and telephone calls to be actioned on day of receipt.
All valid and complete claims to be settled with 14 working days.
To welcome new starters and to advise when required.
To manage and develop the internal and external relationships which allow the claims function to operate effectively and efficiently.
To promote the best image for the company through the professional appearance and behaviour and adhere to company standards and procedures. To maintain the highest level of personal conduct.
It is essential that candidates have experience in a medical claims function within an insurance environment, service provider or health organisation.
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