Claims Assessor

Job Description

Claims Assessor

Dubai, UAE

Permanent

What Youll Do

• To provide excellent customer service for our members.
• The job holder will need to make customer focused actions based on effective decision-making skills. This will also include excellent internal customer service, with continuous contribution given 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.
• To obtain all necessary information on claims for the purpose of complete processing, including liaison with internal departments, using the following methods: telephone or e-mail. This may also include gaining information to research further details required to assess a claim.
• Respond to all relevant incoming correspondence and queries from our internal departments. This will be as per the Claims department key performance indicators, which state turnaround time and quality standards.
• Ensure the correct interpretation of BUPA Internationals policy and rules, using the correct compatible combinations of codes for accurate processing of data, in accordance with our service standards and customer expectations.
• To contribute to the continuous development of the claims process by identifying opportunities for product development and process improvement.
• Suspend claims that require further investigation in order to resolve appropriately to ensure the correct continuation of processing within agreed timeframes and standards in suspend process.
• Logging claims on the system under correct members registrations, when needed.
• Recognise and challenge possible fraudulent information and proactively seek to clarify and resolve using best method of communication and initiative.
• To comply with and abide by the regulatory requirements at all times
• Work on shift basis according to business need.
  
  

• 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.