Job Description:
Claims Assessor
Cairo
Fixed term, Full Time (40 hours per week) role
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.
Role overview:
To take responsibility for entire claims assessment and claims missing information, requests, process including benefit explanation.
What you’ll do:
• 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.
What you’ll bring:
•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.
•Highly customer focussed
•Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
•Ability to work well alone, as well as part of a Team A knowledge of worldwide currencies and geographical locations is desirable
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