Claims Assessor

Claims Assessors
Dubai, UAE
Hybrid working - ‎4 days working from home, ‎1 day in the office
Permanent
‎6 hours per day, ‎5 days per week
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 and making a better world.
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, around 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),
Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and
Hong Kong (China) as well as regional offices in mainland China, Singapore,
the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador.
ESSENTIAL CRITERIA - please only apply if you have the following:
* Must be a UAE National with family book (that can be provided)
* Must hold a University Degree (with certificate that can be provided)
Role Overview
Control of actions required to resolve customer/provider claims queries within
cost and compliance boundaries. Identify and act upon issues that affect the
customer experience and any cost or risk exposure. Authority as per Bupa
Global Delegated Authorities framework. Will consult with other team members,
Service Managers and the Continuous Improvement Partners.
We service our customer globally around the clock. We ask that you be able
to work ‎6 hour shifts (‎30 hours a week) between ‎08:00 - ‎17:00 including
occasional weekends and public holidays.
What you will do
* Provide excellent customer service for our members.
* 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.
* Input claims into the computer system with a high degree of accuracy.
* 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 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.
* 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 regulatory requirements at all times
What you will bring
* Must be a UAE National with family book (that can be provided)
* Must hold a University Degree (with certificate that can be provided)
* 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.
* Experience in a position with a medical background is desirable
* Highly customer focused
Time Type:
Full time
Job Area:
Locations:
Dubai - OIC