Claims Representative (GEH) - Provider Service Organisation

Role Overview

In this entry-level claims role, you will review and process international medical, dental and vision claims, applying the relevant policy terms while working to clear daily instructions and close supervision. Your work helps providers and customers receive accurate decisions and timely answers, while supporting service and quality targets across the European operation.

Key Responsibilities

• Assess and adjudicate healthcare provider claims against applicable policy terms and conditions, meeting individual and team accuracy and productivity targets.
• Review claims for unusually high costs and alert the appropriate colleagues so they can take any required action.
• Track claim turnaround times, work to agreed deadlines and raise delays with your supervisor when a target may be missed.
• Respond to enquiries about plan design, eligibility and claim status within the promised timeframe, resolving queries at first contact where possible.
• Work with internal teams and external providers to investigate and resolve provider issues, taking ownership of the assigned country cluster.
• Complete accurate data entry, maintain claim records and provide administrative support as required.
• Suggest practical ways to improve processes and share recommendations with senior team members.
• Support colleagues and take on work across the European business or other ad hoc tasks as service needs require.

Requirements & Qualifications

• Strong attention to detail and a consistent, accurate approach to handling claims and records.
• Clear written and verbal communication skills, with confidence dealing courteously with internal and external customers.
• A customer-focused approach and the ability to investigate issues, use sound judgement and identify workable solutions.
• Ability to organise and prioritise a varied workload, manage competing tasks and contribute to shared targets.
• Proactive and able to use initiative within established procedures, including suggesting improvements.
• Working proficiency with Microsoft Office applications.
• Experience in medical administration, claims processing or a contact centre is an advantage, but is not essential.
• English and arithmetic qualifications are preferred.