Claim Benefit Specialist, Farnborough - 60223BRPrimary Location: Farnborough, United Kingdom
Additional Locations: HANTS-Farnborough Apply
Aetna are a leading diversified health care benefits company, serving an estimated 44 million people. We offer industry-leading information, tools and resources to help people achieve their best possible health. A Fortune 4 company, Aetna is the third largest health care benefits company in the United States.
Aetna’s global business, Aetna International, is one of the world’s largest and most prominent providers, with more than 650,000 members worldwide and a direct settlement network of over 125,000 hospitals and clinics.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare across the globe. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
As well as some excellent benefits and a fantastic working environment, we will give you the space to grow and provide you with opportunities to learn new skills to keep you developing personally and professionally.
Join us and help turn health ambitions into achievements.
About the role
Have you got experience working within the insurance sector?
We are looking for an enthusiastic Claims Specialists to join our amazing Claims team. As our Claims Benefit Specialist, you will be responsible for proactive case management and building customer relationships.
We have a great culture at Aetna International, you’ll enjoy a fast-paced working environment and have the opportunity to make decisions and make a difference.
It’s a great opportunity to develop your career as we’ll also support you to progress towards CII qualifications!
Your typical day will include:
•Analyse and approve claims.
•Assess claims (up to given Authority limit)
•Proof claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre-coding requirements.
•Investigate claims for possible abuse and fraud.
•Conduct outreach activities including but not limited to email, member calls, provider calls as part of the claims adjudication process
•In accordance with prescribed operational guidelines, manage claims on desk, route/queues, and all systems within specified turn-around-time parameters.
•Escalate unresolved claims complaints and high costs claims to the claims supervisor for guidance.
What you’ll need
•Previous experience working within an insurance and/or claims environment
•Experience working within a customer facing role
•Excellent time management and organisational skills
•First-rate communication skills – face-to-face, written and telephone.
•Discretionary annual bonus
•7% Company Pension
•Private healthcare + discounted lifestyle benefits including gym membership, flights & hotels, Starbucks, cinema tickets
•Income protection insurance
•25 days holiday plus bank holidays – rising to 30 days after 5 years!
•We’ll help you grow by providing support for your professional development
•Fresh fruit and drinks
•Monthly employee appreciation lunches
•Social activities – we work hard but like to have fun too!
•Well-being initiatives to keep you healthy
We’d love to hear from you, so don’t forget to follow us on Twitter, LinkedIn or find us on Facebook!
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