Claims Administrator Fluent German
Job Type : Permanent, Full Time
Salary : £20000 – £22500/annum pension paid holidays
Claims Advisor/Administrator – Fluent German Oral and Written is a must have requirement for this role.
Up to £22,500
Poole
Hours are 8am to 4.30pm Monday to Friday
Are you an experienced Claims Advisor/Administrator with Fluent German language? This is a great opportunity to work with a leading Private Medical Insurance company in a friendly family atmosphere.
Our claims advisors are very often the first point of contact for our customers when making a claim – and with your combination of German medical knowledge and language skills, we have a unique and challenging role for you. Our worldwide insurance policy is dedicated to providing high levels of cover for expats across the globe and we have a particular concentration of policyholders living and working in Germany whose claims require specialist handling.
You will become the focal point for managing these claims. This means receiving the claim documentation – in German – and providing a clear translation of all documentation so all aspects of the claim can be fully and fairly validated before payment.
Responsibilities
* Receive, translate and assess German claims documentation in order to establish:
* The medical condition requiring treatment;
* What medical treatment received;
* Whether the medical treatment received is appropriate and proportionate for the condition; and
* Whether the costs are reasonable.
* Where further information is needed, to undertake those investigations to obtain the information required by contacting the customer, the agent or the medical provider as necessary
* Validate the claim against policy terms and conditions and prepare the final paperwork for reimbursement or declinature.
* Identify and escalate serious and / or urgent cases to the Team Leader and Claims Manager.
* Provide guidance concerning the clinical necessity and appropriateness of medical treatment within the context of the German medical culture combined with the insurance policy terms and conditions.
* Liaising with internal or external people, including medical personnel, to discuss medical conditions and complex cases where required and record findings accurately.
* Audit of invoices to support cost containment activity including the identification of potential cases of unnecessary or excessive medical services or unreasonable charging in accordance with German law and / or best practice.
* Assist the Underwriting team in reviewing medical information provided by prospective new policyholders to identify, assess and manage the risk presented.
* Translation of documents
Essential education and experience
* Experience of working in or with Insurance
* Fully fluent in German with excellent and confident communication skills,
* Computer literate and proficient in the use of Microsoft Office
