Customer Service Representative

Job Description

We are recruiting Customer Service Representatives to joint our Medical Claims team at Healix Health Services in Bristol. If you have Customer Service Experience and are interested in joining our growing team, then please read on!The Job title will be Medical Claims Assessor, even though the job title has Medical in it, you dont need to have any medical knowledge for this job. In the role, you will be responsible for coordinating member treatment plans, you will be liaising withall members of the healthcare team and the member to ensure that all parties have the relevant information, and the member receives appropriate medical information and access to required medical services. Our Medical Claims Assessor team is supported by qualifiednurses.PERSON SPECIFICATIONWe are looking for an individual with the following areas of expertise:

• High standard of customer service and ability to demonstrate customer led thinking.
• Decision making skills and ability to use own initiative.
• A diplomatic open style and approach, with excellent verbal and written communication.
• A high degree of accuracy and attention to detail and work well under pressure.
• The ability to work well both independently and as part of a team.
• Good problem solving and analytical skills.
• Good commercial awareness with the ability to make decisions with the "bigger picture" in mind.

The following experience is preferential but not a requirement:

• A good understanding and previous experience of the private medical insurance industry and claims processing, would be an advantage.
• The ability to understand clients’ requirements and ability to locate and interpret all relevant policy documentation.

About The RoleKEY ACTIVITES/MAIN DUTIES

• Take calls from clients, providers and specified members in relation to initial and/or ongoing claims.
• Obtain medical evidence from providers to substantiate claims decision/treatment.
• Deal with queries in relation to clinical treatment or pre-authorisation requests.
• Arrange care with the appropriate medical team/facility.
• Ensure treatment delivered is relevant and appropriate by monitoring ongoing treatment plans for members.
• Negotiate provider fees within the Healix Reasonable and Customary fees, as part of cost containment for clients.
• Ensure all documents are correctly and accurately allocated on Case Management SystemAssisting the Case Managers with high cost claims where required.We are looking for a number of Medical Claims Assessors to start with us mid November and would like to invite candidates for an assessment day on either the 3rd of November and the 8 or 9th of November (TBC). If you would like to work in a friendlyenvironment and feel you have a customer focused mindset, then we would love to hear from you.Required Criteria
  • Do you have Customer Service Experience
  • Do you have a good command of the English language
  Desired Criteria
  • Do you have medical claims handling experience
  Skills NeededCompany CultureInstead, we focus on ensuring our highly trained specialists have the space and time they need to be effective. We let them use their initiative to get the job done, because the situations they face often throw up unexpected challenges - and no protocolsurvives contact with the real world.Our clients have thousands of employees and customers, at home and abroad, so they need a business big enough to handle any situation. But they chose Healix because they also need an organisation that’s personal enough to care.Our people are driven to do things in the best way, not the way they have always been done. We work hard, and our efforts are rewarded with great development opportunities and a supportive team spirit.We want to nurture this friendly and dynamic company culture so that we can continue to attract diverse talent with a breadth of knowledge and world-class skills. As a part of Healix, you can expect a range of excellent benefits and an environment wherepeople really do care.Company BenefitsCommitment to career developmentWe are committed to helping our people build and develop successful careers. Our employees are given direct responsibility and opportunity to develop and grow whilst working on challenging and worthwhile projects in a rewarding and supportive environment.We invest in the continuous development of our team, offering on-going training and professional enhancement opportunities for those wishing to diversify or take additional responsibilities.Health insurance, Vacation, Paid time off, Retirement plan and/or pension, Office perks, Employee development programs, Employee discounts, Gym membership or wellness programs, Opportunity to travel, Casual dress, Cycle to work, Open office, Competitivesalary, Life insurance, Employee Assistance Scheme, Wellbeing Scheme, Social Opportunities, Hybrid WorkingSalary£26,000.00 - £30,000.00 per year

Keyskills :
Claims Management Written Communication Call Management teamwork