Ireland Job Openings
Irish Life
Health Claims Service Team Lead
Dublin
FULL TIME
September 3, 2024
- Full Time Permanent position
- Hybrid role based in our City Centre offices/Cork Office
We offer a comprehensive benefits package including competitive salaries and bonuses, robust Learning and Development support, excellent Defined Contribution pension and comprehensive Wellbeing initiatives and support to name but a few.
Further details on our benefits package can be accessed here Benefits (life-careers.com)
- Focusing on delivering customer first solutions to maximise our customer experience.
- Day to day co-ordination of the team service levels and workload.
- Oversight of the service levels for our providers interaction activities (Voice & Email) and ensuring KPIs are met.
- Complete governance audits for all claims and verify all minimum audit levels are met in line with our Quality Assurance Strategy.
- Ensure all governance requirements are adhered to and are fully auditable.
- Act as the first line of defence and identify any potential areas of inappropriate billing, fraud and abuse of the hospital and member claims process.
- Actively manage all team mailboxes in line with agreed KPIs.
- Identify and report on any ineffective or inefficient controls or claims processes and provide inputs and recommendations into the correction of issues identified to Senior Management.
- Assist in the production and delivery of training materials for our TPA partners to ensure that the agreed processes and procedures are rolled out effectively in a controlled manner.
- Lead by example and uphold the standards of professionalism expected of the team.
- Build positive and proactive working relationships across the organisation as well as with our TPAs.
Skills & Experience
- Be a self-starter and willing to act on own initiative
- Ability to manage a demanding workload while co-ordinating work effectively across the team
- Ability to lead by example and drive standards of professionalism within team
- Experience in health insurance with an excellent knowledge of claims processes, assessment rules, policy terms and conditions are desirable
- A good understanding of the principles of governance is desirable
- Excellent communication and interpersonal skills
- Act as part of a team and give full participation and commitment to fellow team members to meet common goals
- Good system knowledge and use of Microsoft Office
This role is a ‘controlled function’ as defined by the Central Bank Reform Act 2010 Regulations 2011. Any appointment will be conditional on the company being satisfied that the appointee meets the requirements as set out in the Fitness and Probity standards issued by the Central Bank. This requires the company to complete prescribed due diligence to assess the appointee’s fitness and probity. Further details on this due diligence process are available from CLE Human Resources.
Irish Life Health supports Equal Opportunity and is regulated by the Central Bank of Ireland.
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