The Claims Officer role oversees an integral part of our process for the healthcare provided to eligible EEA and Swiss citizens in accordance with reciprocal healthcare agreements. You will be working as part of Overseas Healthcare Services within Citizen Services.
What do we offer?
1. 27 days leave (increasing with length of service) plus 8 bank holidays
2. Flexible working (we are happy to discuss options such as compressed hours)
3. Flexi time
4. Hybrid working model (we are currently working largely remotely)
5. Career development
6. Active wellbeing and inclusion networks
7. Excellent pension
8. NHS Car lease scheme
9. Access to a wide range of benefits and high street discounts!
Main duties of the job
Working as part of a team, the Claims Officer will use their analytical skills to review and assess finance data and records submitted by healthcare facilities, EEA member states and Switzerland in order to process the claims for reimbursement in accordance with agreed procedures, policy and technical instructions.
A key element of the role involves working with internal and external stakeholders and customers; therefore, the Claims Officer will need a high level of communication and customer service skills to approach this role effectively. The Claims Officer will use existing and newly developed communication and case management systems and should be comfortable in adapting to regular changes to processes and improvements to technology.
This role will initially be home-based, but you must be able to attend the office in Newcastle and can commence travel when appropriate.
Job responsibilities
In this role, you are accountable for:
1. Ensuring all claims processing is carried out in accordance with Governance frameworks, policies and procedures ensuring that accurate and auditable records of activities are maintained.
2. Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.
3. Self-managing and planning your own daily workloads to ensure optimally effective outputs.
4. Collating and interpreting information obtained from business records, other business areas and stakeholders.
5. Understanding/interpreting regulations and analysing data to enable well informed evidence-based decisions to be made.
6. Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures.
7. Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions.
8. Communicating effectively with customers and internal/external stakeholders, resolving and answering enquiries on own initiative to provide an excellent level of written and verbal customer service.
9. Dealing with all situations encountered in a professional and productive manner.
10. Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required.
11. Ensuring your objectives are developed and owned that in turn fully support the service objectives.
12. Working to agreed internal performance and accuracy targets.
13. Working in an organised manner and complying with office systems in place to ensure that paperwork relating to individual and member states claims is kept together and can be easily and quickly retrieved.
14. Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues.
15. Undertaking any other duties and responsibilities as agreed with your line manager and commensurate with your role.
Person Specification
Qualifications
* Minimum of 3 GCSE's (or equivalent) at Grade C or above, including English and Mathematics, or can demonstrate equivalent work experience or further education.
* Demonstrable ability to use own initiative.
Experience
* Demonstrable experience in a post involving data validation and analysis.
* Experience of understanding and following detailed technical instructions.
* Experience in personally resolving a variety of complex queries.
* Experience of working under pressure to strict guidelines and deadlines.
* Experience of working in a customer service environment or a clerical environment.
* Worked in NHS or similar large organisation.
* Experience of using Case Management systems.
* Experience of providing written communication to customers.
Personal Qualities, Knowledge and Skills
* IT literate in Microsoft packages, able to use databases, word processing, spreadsheets to enable accurate analysis and reporting.
* Ability to follow procedures and interpret policy and regulations.
* Understanding of the Information Governance principles, including the Data Protection Act.
* Excellent communication skills both written and verbal.
* Adaptable, with proven ability to respond to and switch between wide varieties of queries effectively and with limited notice.
* Proven time and self-management skills.
* Ability to understand and memorise information, working quickly and accurately with an eye for detail.
* Understanding of reciprocal healthcare arrangements in the EEA & Switzerland.
* Ability to deal with dissatisfied customers.
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