Claims Officer Job Description
The Claims Officer role is a vital part of our process for providing healthcare to eligible EEA and Swiss citizens under reciprocal healthcare agreements. You will be part of the Overseas Healthcare Services within Citizen Services.
What do we offer?
* 27 days leave (increasing with length of service) plus 8 bank holidays
* Flexible working options, including compressed hours
* Flexi time and a hybrid working model (currently largely remote)
* Career development opportunities
* Active wellbeing and inclusion networks
* Excellent pension scheme
* Access to a wide range of benefits and discounts
Main duties of the job
The Claims Officer will review and assess finance data and records submitted by healthcare facilities, EEA member states, and Switzerland to process reimbursement claims according to established procedures, policies, and instructions.
This role requires strong communication and customer service skills to work effectively with internal and external stakeholders. The officer will utilize existing and new communication and case management systems, adapting to process changes and technological improvements.
This position is initially home-based but requires attendance at the Newcastle office and potential travel when necessary. Interviews will be held at Bridge House Newcastle. Applications may close early if a high volume is received.
About Us
The NHS Business Services Authority (NHSBSA) manages various NHS services, including the NHS Pension scheme and prescription payments. Our mission is to serve NHS organizations, contractors, and the public, making a meaningful difference in millions of lives.
We prioritize customer needs and support our staff's growth. Recognized as one of the UK's Best Big Companies, our values include Collaboration, Adventure, Reliability, and Energy. We promote wellbeing, diversity, and inclusion, encouraging participation in our Lived Experience Networks.
We offer flexible working arrangements, competitive salaries, and a comprehensive benefits package. Join us in delivering excellent NHS services and helping people lead healthier lives. Apply today and discover where NHSBSA can take your career.
We are people connected to care.
Job Description
In this role, you are accountable for:
* Ensuring claims processing complies with governance frameworks, policies, and procedures, maintaining accurate, auditable records.
* Adhering to GDPR and quality standards.
* Managing your daily workload efficiently, operating within Service Level Agreements and policies, and keeping standard operating procedures up to date.
* Gathering and analyzing information from records, stakeholders, and other sources.
* Interpreting regulations and data to support evidence-based decisions, communicating with the DHSC policy team on exceptional cases, and escalating issues when necessary.
* Producing data on claims activities and recommending actions for reviews of reciprocal healthcare arrangements.
* Liaising with member states, customers, and stakeholders to discuss cases and reach conclusions.
* Providing excellent written and verbal customer service, resolving inquiries proactively.
* Handling situations professionally and productively.
* Participating in reviews, audits, and quality assurance activities to improve Overseas Healthcare operations.
* Setting and working towards objectives that support service goals.
* Meeting internal performance and accuracy targets, monitoring personal achievements, and receiving feedback.
* Organizing paperwork for claims to ensure quick retrieval.
* Following Health and Safety procedures and understanding Equality and Diversity issues.
* Performing additional duties as assigned by your line manager.
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