Claims officer - French Speaker

The role of Claims Officer involves processing medical claims for client's worldwide, form Australia to Germany and Brazil to the Netherlands, all countries are catered for.



Main Responsibilities:

-Adjudicate and process Claims within the agreed company SLA - clear to zero, in accordance with policy benefits to facilitate the company achieving its loss ratio target
-Use AWC`s client database accurately and effectively to ensure reports generated give a true reflection of the department`s workload, which consequently facilitates effective target planning
-Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention
-Contribute to the team and departmental productivity targets so that the agreed SLA is achieved and a high level of customer service is provided.
-In line with the company`s policy on cost containment identify duplicate payments, possible non-disclosure and fraudulent claims
-Respond to customer enquiries accurately and professionally and if necessary, liaise
with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction
-Participate in departmental medical training to expand knowledge of medical terminology and procedures and to develop comprehensive claims processing skills
-Other Ad hoc duties as required
Experience Required
-Previous experience in a customer focused role, in a an administrative capacity
-Experience working in pressurised environment with tight deadlines
-Fluency in English and German is essential to this role



Behavioural Competencies

-Customer focused
-Strong communication (verbal & written)
-Ability to work effectively within a team environment
-Honesty and Integrity
-Ability to work under pressure
-Results driven and solution oriented