Medical Claims Advisor

Are you looking for a rewarding career in the private medical industry? Do you have excellent customer service skills and a passion for helping people? If so, you might be the perfect fit for our Member Advisor role! We are looking for candidates who can start with us early July.

As a Member Advisor you will be responsible for coordinating member treatment plans, liaising with all members of the healthcare team and the member, and ensuring that the member receives appropriate medical information and access to required medical services. This is a role where good customer service skills are key, and you are not required to have any medical qualifications.

PERSON SPECIFICATION

We are looking for an individual who can deliver great customer service and who has strong command of the English language, both verbal and written.

In addition, we are looking for:

• 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.
• Ability to make effective contact with clinicians, accurate assessment of information obtained and acting appropriately upon the outcome.
• An overall external awareness of new technology or development within the industry to pre-empt and be prepared for possible related queries.

A good understanding and previous experience of the private medical insurance industry and claims processing, would be an advantage.

About The Role

AS MEMBER ADVISOR, YOU WILL BE INVOLVED IN:

• Taking calls from clients, providers and specified members in relation to initial and/or ongoing claims
• Obtaining medical evidence from providers to substantiate claims decision/treatment
• Dealing with queries in relation to clinical treatment or pre-authorisation requests
• Arranging care with the appropriate medical team/facility
• Ensuring treatment delivered is relevant and appropriate by monitoring ongoing treatment plans for members
• Negotiating provider fees within the Healix Reasonable and Customary fees, as part of cost containment for clients
• Ensuring all documents are correctly and accurately allocated on Case Management System
• Assisting the Case Managers with high cost claims where required

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 Needed

Company Culture

Instead, 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 protocol survives 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 where people really do care.

Company Benefits

Commitment to career development

We 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, Free work laptop, Referral bonus, Open office, Competitive salary, Life insurance, Employee Assistance Scheme, Wellbeing Scheme, Social Opportunities, Hybrid Working

Salary

£27,100.00 per year