Claims Assessor - Adjustments
Job Description:
Claims Assessor - Adjustments
Manchester
Hybrid
Permanent
£23,000 + fantastic benefits
Full time
Working in our UK support functions you'll play a key part in helping our customer facing colleagues deliver exceptional standards of customer service and patient care. No matter your role, you'll have an opportunity to do work that matters. Making a difference to the lives of our customers each and every day.
Role Overview:
The Claims Assessor - Adjustment will work together to safeguard the integrity of all adjustments and provider aged debt activity against £1. 2bn of benefit spend each year. Working as a member of the Customer Support Claims team, you will have a relentless focus on Payment Integrity, ensuring we only pay what we should first time, every time.
What you'll do:
- All work is completed to agreed quality standards and within SLA timescales.
- All inappropriate charges are identified and challenged across the business before any adjustment or aged debt outcome is finalised.
- Proactively own all provider communication to enable them to fully understand our outcomes and rationale.
- Consistently display a continuous improvement mindset, identifying trends and removing all causes of failure
- Support, challenge and collaborate with outsourced partners to achieve agreed business outcomes.
- Fully observe all authority levels, regulatory and mandatory training requirements
- You confidently liaise with other teams, providers, and customers (via phone, email or in person) where necessary.
- All Adjustments for UK PMI and dental claims are investigated to verify they comply with Bupa's products, policies and contractual agreements and processed in line with the procedures appropriate to the original claim (e.g., high cost, high risk or specially handled)
- You assist in building and maintaining strong relationships with Third Party clients or partners to support continued growth.
What you'll bring:
- Numerate, with excellent written and verbal communications.
- Strong passion for delivering better outcomes for our customers and commercial benefits for Bupa
- The ability to work to tight deadlines under pressure.
- Able to adapt to changing priorities and deliverables.
- Technically proficient with an aptitude to learn new systems quickly.
- Good analytical problem-solving skills with strong attention to detail
- Ability to make appropriate decisions based on the evidence presented and escalate where appropriate.
- Ability to take advice from others around the organisation and question these experts appropriately.
Why Bupa?
We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.
Our benefits are driven by what matters to our people. It's important to us that these benefits support a work-life balance that keeps people healthy, both mentally and physically. You will be eligible for:
- 25 days holiday, increasing through length of service, with option to buy or sell
- Bupa health insurance as a benefit in kind
- An enhanced pension plan and life insurance
- Annual performance-based bonus
- Onsite gyms or local discounts where no onsite gym available
- Various other benefits and online discounts
Diversity and Inclusion
Bupa is committed to making sure that every applicant is assessed solely on personal merit and qualifications. We actively celebrate the diversity of our colleagues and provide an inclusive environment so you can bring your true self to Bupa. We'll make sure you are treated fairly. That's why we're happy to offer reasonable adjustments as part of our recruitment process to anyone that needs them.
Whether you've found your feet or are discovering a new path.
Welcome to a place that celebrates you.
This isn't where you've been.
This is where you're going.
This is what we have belief in.
Time Type:
Full timeJob Area:
AdministrationLocations:
Bupa Place