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Senior Eligibility Officer
2 months ago
We are seeking a highly skilled and experienced Senior Eligibility Officer to join our team at GB - Global. As a key member of our organization, you will play a critical role in ensuring the effective management of complex claims and providing expert guidance to our customers.
Key Responsibilities- Manage a portfolio of complex and scheme-critical claims, ensuring timely and accurate decision-making.
- Conduct thorough eligibility assessments, reviewing and evaluating complex claims, medical records, legal documents, and supporting documentation to determine claim eligibility.
- Develop and maintain expertise in eligibility and compensability, providing subject matter guidance to the team.
- Collaborate with stakeholders to develop and implement effective claim strategies and interventions.
- Participate in training and development programs to enhance technical knowledge and skills.
- Identify opportunities for process improvement and contribute to the evolution of our eligibility processes.
- Proven experience in complex claims management or a related field.
- Strong knowledge of complex claims eligibility criteria and processes.
- Bachelor's degree in Insurance, Legal Studies, or Healthcare is highly desirable.
- Demonstrated knowledge of the Return to Work Act and its application is desirable, but not essential.
- Excellent customer service, communication, and interpersonal skills, with a strong team player attitude.
- Demonstrated high levels of autonomy and a learning mindset.
- Experience working in a dynamic, fast-paced environment.
- A competitive salary and benefits package.
- Opportunities for career growth and professional development.
- A dynamic and supportive work environment.
- Flexible and hybrid working arrangements.
- A range of staff benefits, discounts, and wellbeing programs.
GB - Global is a leading organization in the industry, committed to delivering exceptional outcomes for our customers. We value diversity, inclusion, and collaboration, and are dedicated to creating a positive and supportive work environment.
