Claims Officer

Job overview

The Claims Officer role overseas an integral part of our process 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.

• 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 (we are currently working largely remotely)
• 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.

This role will initially be home based, but you must be able to attend the office in Newcastle and can commence travel when appropriate.

Interviews will take place at Bridge House Newcastle.

If we receive a high volume of applications, we may decide to close the vacancy early.

Working for our organisation

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’re proud to be part of something meaningful, that touches millions of lives.

We design our services around customer needs and place people at the heart of our organisation. That’s why when you join us, you’ll be empowered and supported to help your career grow.

As one of the UK’s Best Big Companies to work for, we’re 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 colleague is heard, supported and respected. Wellbeing, diversity and inclusion is at the centre of this, and you can join our Lived Experience Networks who help us bring our authentic selves to work.

We’re committed to being a flexible employer and we try to offer a working pattern that suits you where possible, through hybrid working, flexible hours and more.

Alongside a competitive salary with pay progression, we offer a people-centric benefits package, connecting you to the rewards and benefits you value most!

Ready to join us in delivering business service excellence to the NHS, helping people live longer, healthier lives? Apply today and see where the NHSBSA can take you.

We are people connected to care.

Detailed job description and main responsibilities

1. 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.
2. Adhering to the General Data Protection Regulation (GDPR) and working in accordance with quality standards.
3. 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.
4. Collating and interpreting information obtained from business records, other business areas and stakeholders.
5. 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.
6. Maintaining and producing data highlighting claims activities including recommendations for further action in preparation for reviews of reciprocal healthcare arrangements or procedures.
7. Liaising with member states, customers and any relevant internal and external stakeholders to discuss cases and seek conclusions.
8. 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.
9. Dealing with all situations encountered in a professional and productive manner.
10. Contributing to the ongoing review and development of our Overseas Healthcare operations, ad hoc audits and other quality assurance activities as required.
11. Ensuring your objectives are developed and owned that in turn fully support the service objectives.
12. Working to agreed internal performance and accuracy targets. Agreeing realistic personal targets, monitoring and evaluating own achievements, with timely and constructive feedback.
13. 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.
14. Adhering to Health and Safety procedures and ensuring personal knowledge of Equality and Diversity issues.
15. Undertaking any other duties and responsibilities as agreed with your line manager and commensurate with your role.

Person specification

Qualifications

• 1. Minimum of 3 GCSE’s (or equivalent) at Grade C or above, including English and Mathematics, or can demonstrate equivalent work experience or further education

• 1. Demonstrable ability to use own initiative

Experience

• 1. Demonstrable experience in a post involving data validation and analysis.
• 2. Experience of understanding and following detailed technical instructions.
• 3. Experience in personally resolving a variety of complex queries.
• 4. Experience of working under pressure to strict guidelines and deadlines.
• 5. Experience of working in a customer service environment or a clerical environment.

• 1. Worked in NHS or similar large organisation.
• 2. Experience of using Case Management systems.
• 3. Experience data entry.
• 4. Experience of providing written communication to customers.

Personal Qualities, Knowledge and Skills

• 1. IT literate in Microsoft packages, able to use databases, word processing, spreadsheets to enable accurate analysis and reporting.
• 2. Ability to follow procedures and interpret policy and regulations.
• 3. Understanding of the Information Governance principles, including the Data Protection Act
• 4. Excellent communication skills both written and verbal.
• 5. Adaptable, with proven ability to respond to and switch between wide varieties of queries effectively and with limited notice.
• 6. Proven time and self-management skills.
• 7. Ability to understand and memorise information, working quickly and accurately with an eye for detail

• 1. Understanding of reciprocal healthcare arrangements in the EEA & Switzerland.
• 2. Ability to deal with dissatisfied customers.

We also welcome applications from all those in the Armed Forces Community.

At the NHSBSA we pride ourselves on being a Disability Confident Leader, Stonewall Top 100 employer and we’ve recently been awarded the Employers Network for Equality and Inclusion Gold Standard benchmark.

We offer an invitation to the first stage of the selection process for people with disabilities that wish to be considered under the Disability Confident scheme, and for members of the Armed Forces Community, where all of the essential criteria in the person specification are met.

A copy of our Privacy Notice is available to view at the link below:

NHSBSA Privacy Notice