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- Location: Berkshire
- Job Reference: #HH1321/J1647
- Job Type: Permanent
- Category: Claims
Our client seek a Medical Advisor to review incoming Medical claims. The role will include collaboration with Clients, Brokers, Underwriters, Third Party Administrators, Assistance providers and Internal service providers.
To review all claims that require pre-authorisation and ensure that consideration has been given to pre-existing conditions and that cost containment measures have been taken.
To ensure that TPAs are assessing claims in accordance with the terms and conditions of the company policies.
To work with the team to introduce medical underwriting on required business (individual and small group).
To consider appropriate wording on any exclusions to be applied on policies.
To ensure that all statutory and company regulations are followed to protect clients, colleagues and the business interests of the company.
To contribute to a supportive and flexible working environment, taking responsibility for situations as and when required.
Prior experience in a nursing / healthcare environment
A good understanding of the international healthcare claims market would be preferable.
Experience in a health insurance or insurance company would be preferable.
Strong commercial acumen
Good time management and organisational ability
Innovative problem solving skills
Good analytical skills
Excellent written and verbal communication skills
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