Claims Assessor

Bupa; United Arab Emirates; On-site; AED 120,000 - 200,000; Full time

Job summary

A global health insurance provider is seeking a Claims Assessor in Dubai. This role involves providing excellent customer service, managing claim-related queries, and ensuring compliance with insurance policies. The ideal candidate must possess a medical degree and have at least 2 years of experience in a claims role within the healthcare sector. Strong interpersonal and decision-making skills are crucial. This is a full-time position in the call center area.

Qualifications

• Strong background in the global health insurance sector or related financial services.
• At least 2 years of experience in claims role required.
• Experience in healthcare-related claims assessment.

Responsibilities

• Provide excellent customer service for members.
• Action claim-related queries in line with policy.
• Log claims under correct member registrations.
• Recognise and challenge possible fraudulent information.

Skills

Customer-focused mindset

Interpersonal skills

Communication skills

Ability to meet productivity targets

Decision-making skills

Education

Medical degree

Job description

Overview

Claims Assessor

Dubai, UAE

Permanent

What you’ll do:

• To provide excellent customer service for our members.
• Make customer-focused actions based on effective decision-making skills; provide excellent internal customer service, with continuous contribution towards achieving individual, team and department goals and objectives; inputting claims into the computer system with a high degree of accuracy.
• To action any claim-related query in line with Bupa Global policy and style; obtain all necessary information on claims for the purpose of complete processing, including liaison with internal departments via telephone or e-mail, and researching further details required to assess a claim.
• Respond to all relevant incoming correspondence and queries from internal departments in line with the Claims department key performance indicators (turnaround time and quality standards).
• Ensure the correct interpretation of BUPA International’s policy and rules, using the correct compatible combinations of codes for accurate processing of data, in accordance with service standards and customer expectations.
• Contribute to the continuous development of the claims process by identifying opportunities for product development and process improvement.
• Suspend claims that require further investigation to ensure correct continuation of processing within agreed timeframes and standards in suspend process.
• Log claims on the system under correct members’ registrations, when needed.
• Recognise and challenge possible fraudulent information and proactively seek to clarify and resolve using the best method of communication and initiative.
• To comply with and abide by the regulatory requirements at all times.
• Work on a shift basis according to business needs.

What you'll bring:

• Strong background in the global health insurance sector, or relevant transferable expertise gained from related financial services industries such as life insurance, retail banking, commercial banking, investment banking, or wealth management.
• Experience at least for 2 years in claims role is a must.
• A medical degree is mandatory.
• Demonstrated ability to meet and exceed productivity and quality performance targets.
• Customer-focused mindset with a commitment to delivering high-quality service.
• Exceptional interpersonal, communication, and influencing skills, with a strong focus on achieving successful outcomes.
• Prior experience in delivering customer service.
• Proven background in healthcare-related claims assessment.

Time Type: Full time

Job Area: Call Centre

Locations: Dubai - OIC