Job summary
The Claims Officer role is an integral part of processing claims 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?
- 27 days leave (increasing with length of service) plus 8 bank holidays
- Flexible working (we are happy to discuss options such as compressed hours)
- Flexi time
- Hybrid working model
- Career development
- Active wellbeing and inclusion networks
- Excellent pension
- NHS Car lease scheme
- 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.
The interview will be a face to face interview.
If we receive a high volume of applications, we may decide to close the vacancy early.
About us
Here at the NHS Business Services Authority (NHSBSA), what we do matters.
We manage the NHS Pension scheme, process prescription payments and much more. Our services are used by NHS organisations, contractors and the public: we take pride in being part of something so meaningful, that touches millions of lives.
Just as we design our services around the needs of our customers, we place our people at the heart of our organisation. That's why when you join us, you'll be empowered and given the right support to help your career grow.
As one of the UK's Best Big Companies to work for, we're all connected to our values: Collaborative, Adventurous, Reliable and Energetic. We care about our people, our purpose, and your progress.
We strive to offer a fantastic colleague experience, where every voice is heard, and every colleague is supported and respected. Wellbeing, diversity and inclusion is at the centre of this, so when you join us, you can connect with our Lived Experience Networks who help us to bring our authentic selves to work.
We welcome applications from people of all backgrounds and circumstances. We are committed and proud to be a flexible employer and will endeavour to offer a working pattern that suits you wherever possible, whether that be hybrid working, flexible hours, job sharing and more.
Ready to join us on our journey to be a catalyst for better health? Apply today and see where the NHSBSA can take you.
We are people connected to care.
Job description
Job responsibilities
In this role, you are accountable for:
- 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.
- Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.
- Self-managing and planning your own daily workloads to ensure optimally effective outputs. Operating all services in line with Service Level Agreements, internal agreements/ policies within agreed time scales and ensuring all personal copies of standard operating procedures are up to date.
- Collating and interpreting information obtained from business records, other business areas and stakeholders.
- Understanding/interpreting regulations and analysing data to enable well informed evidence based decisions to be made. Communicating with DHSC policy team to deal with exceptional cases when necessary and escalating cases to the Service Delivery Manager when appropriate.
- Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures.
- Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions.
- 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.
- Dealing with all situations encountered in a professional and productive manner.
- Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required.
- Ensuring your objectives are developed and owned that in turn fully support the service objectives.
- Working to agreed internal performance and accuracy targets. Agreeing realistic personal targets, monitoring and evaluating own achievements, with timely and constructive feedback.
- 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.
- Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues.
- Undertaking any other duties and responsibilities as agreed with your line manager and commensurate with your role.
Job description
Job responsibilities
In this role, you are accountable for:
- 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.
- Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.
- Self-managing and planning your own daily workloads to ensure optimally effective outputs. Operating all services in line with Service Level Agreements, internal agreements/ policies within agreed time scales and ensuring all personal copies of standard operating procedures are up to date.
- Collating and interpreting information obtained from business records, other business areas and stakeholders.
- Understanding/interpreting regulations and analysing data to enable well informed evidence based decisions to be made. Communicating with DHSC policy team to deal with exceptional cases when necessary and escalating cases to the Service Delivery Manager when appropriate.
- Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures.
- Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions.
- 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.
- Dealing with all situations encountered in a professional and productive manner.
- Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required.
- Ensuring your objectives are developed and owned that in turn fully support the service objectives.
- Working to agreed internal performance and accuracy targets. Agreeing realistic personal targets, monitoring and evaluating own achievements, with timely and constructive feedback.
- 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.
- Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues.
- Undertaking any other duties and responsibilities as agreed with your line manager and commensurate with your role.
Person Specification
Qualifications
Essential
- oMinimum of 3 GCSE's (or equivalent) at Grade C or above, including English and Mathematics, or can demonstrate equivalent work experience or further education
Desirable
- oDemonstrable ability to use own initiative
Experience
Essential
- oDemonstrable experience in a post involving data validation and analysis
- oExperience of understanding and following detailed technical instructions
- oExperience in personally resolving a variety of complex queries
- oExperience of working under pressure to strict guidelines and deadlines
- oExperience of working in a customer service environment or a clerical environment
Desirable
- oWorked in NHS or similar large organisation
- oExperience of using Case Management systems
- oExperience of data entry
- oExperience of providing written communications to customers
Personal Qualities, Knowledge and Skills
Essential
- oIT literate in Microsoft packages, able to use databases, word processing, spread-sheets to enable accurate analysis and reporting
- oAbility to follow procedures and interpret policy and regulations.
- oUnderstanding of the Information Governance principles, including the Data Protection Act
- oExcellent communication skills both written and verbal
- oAdaptable, with proven ability to respond to and switch between wide varieties of queries effectively and with limited notice
- oProven time and self-management skills
- oAbility to understand and memorise information, working quickly and accurately with an eye for detail.
Desirable
- oUnderstanding of reciprocal healthcare arrangements in the EEA & Switzerland
- oAbility to deal with dissatisfied customers,.
Person Specification
Qualifications
Essential
- oMinimum of 3 GCSE's (or equivalent) at Grade C or above, including English and Mathematics, or can demonstrate equivalent work experience or further education
Desirable
- oDemonstrable ability to use own initiative
Experience
Essential
- oDemonstrable experience in a post involving data validation and analysis
- oExperience of understanding and following detailed technical instructions
- oExperience in personally resolving a variety of complex queries
- oExperience of working under pressure to strict guidelines and deadlines
- oExperience of working in a customer service environment or a clerical environment
Desirable
- oWorked in NHS or similar large organisation
- oExperience of using Case Management systems
- oExperience of data entry
- oExperience of providing written communications to customers
Personal Qualities, Knowledge and Skills
Essential
- oIT literate in Microsoft packages, able to use databases, word processing, spread-sheets to enable accurate analysis and reporting
- oAbility to follow procedures and interpret policy and regulations.
- oUnderstanding of the Information Governance principles, including the Data Protection Act
- oExcellent communication skills both written and verbal
- oAdaptable, with proven ability to respond to and switch between wide varieties of queries effectively and with limited notice
- oProven time and self-management skills
- oAbility to understand and memorise information, working quickly and accurately with an eye for detail.
Desirable
- oUnderstanding of reciprocal healthcare arrangements in the EEA & Switzerland
- oAbility to deal with dissatisfied customers,.
Additional information
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
