Claims Representative (GEH) - Provider Service Organisation

Role Overview

As a member of our international claims team, you will process medical, dental, and vision claims from healthcare providers across multiple countries, ensuring every claim is checked against policy terms and settled accurately and promptly. This is an entry-level professional role where you will learn the fundamentals of claims adjudication while working under clear guidance from a supervisor, with daily tasks assigned and reviewed closely. Your work directly impacts customer trust and operational efficiency, as you help maintain service standards and support the wider European business.

Key Responsibilities

• Review and adjudicate international medical, dental, and vision claims by applying policy terms, conditions, and eligibility rules to each case.
• Meet individual and team targets for both productivity and quality, while maintaining a high level of accuracy in every claim you process.
• Spot high-cost or unusual claims and flag them promptly so that relevant parties can take appropriate action.
• Track turnaround times for your assigned claims and escalate to your supervisor when settlement deadlines are at risk.
• Respond to internal and external enquiries about plan design, eligibility, and claim status, aiming to resolve issues on the first contact wherever possible.
• Take ownership of a specific country cluster of providers, acting as the primary point of contact for resolving provider-related issues.
• Suggest practical process improvements to your team lead based on your day-to-day observations and workflow patterns.
• Support colleagues across the team and the wider European business as workloads shift, including handling ad hoc administrative and operational tasks when required.

Requirements & Qualifications

• Strong customer focus with the ability to identify problems and work toward practical solutions.
• Demonstrated ability to meet or exceed performance targets while juggling multiple priorities in a fast-paced environment.
• Solid working knowledge of Microsoft Office applications, especially Excel and Outlook, for data entry, tracking, and communication.
• Excellent attention to detail and a consistently high level of accuracy in your work.
• Good interpersonal, verbal, and written communication skills for clear interaction with both internal colleagues and external clients.
• Comfortable working independently, taking initiative, and proactively recommending improvements to existing processes.
• Strong organisational and prioritisation skills to manage individual and team workflow effectively.
• Ability to exercise sound judgement when assessing claims and deciding on appropriate actions.
• Preferred qualifications include passes in English and Arithmetic, though relevant experience in medical administration, claims processing, or a contact centre environment is also advantageous but not essential.