ROLE PURPOSE

This role will be responsible for maintaining the unsubmitted ledger for both current and aged claims thus helping to reduce debt by maximising claims submissions and cash collection

Their purpose will be to:

       Deliver timely task achievement

       Ensure all claims are collated correctly, efficiently and submitted in a timely manner, in accordance with the relevant contract or commercial agreement

       Maintain a high standard of quality checking to minimise the occurrence of pended, returned, rejected or part paid claims

       Maintain a minimum level of queried claims on their desks

       Ensure that all patients/staff and any other individuals contacting and attending the Blackrock Clinic are dealt with in an efficient, effective and timely manner at all times and be responsible for their own actions.

1.     KEY RESPONSIBILITIES

       Review Patient claim packs for accuracy and completeness and obtain any missing information required in order to submit the claim for assessment to the relevant Insurer

       Identification of claims with errors that cannot be submitted to the Insurers and being pro-active in trying to resolve them in a timely manner

       Daily scanning and submissions of claims to relevant third party in accordance with their relevant cut-off dates whilst ensuring swift turnarounds along with a high standard of quality

       Assisting in the management of Consultant files ensuring paperwork is chased and received in a timely manner, requesting and copying charts where necessary

       Resolution and resubmission of any VHI returns that come back as quality errors

       Acquire a full understand of the Insurer contracts and the rules of billing and submissions

       Weekly reconciliation of claims submitted to each Insurer between diary entry, OA and the claims summary sheet

       Assisting with filing, cash collection and other ad-hoc duties required

       Deal with routine calls from patients, consultants and staff, resolving daily or escalating to your Team Lead if further action is required but taking responsibility for ensuring the notes in OA are kept up to date and assisting where possible to close out the query. A professional and courteous approach is expected at all times, for both internal and external stakeholders

       Supporting the standardisation and improvement of processes, procedures, controls, and systems

       Utilisation of Excel and Word Processing skills to maintain up-to-date spreadsheets and statistics

       Contributing to the delivery of key department KPI's and targets

2.     SKILLS AND EXPERIENCE

       Numerical and analytical skills

       Interest in change management and process improvement

       Proficient in Microsoft Excel

       Excellent communication skills both verbal & written

       Flexible

       Positive attitude

3.     COMMUNICATION SKILLS

       Communicate appropriately with colleagues and other members of the health care teams to ensure a quality service is provided to all while constantly striving for excellence in patient/customer care.

       Communicate in a manner that avoids antagonism, reduces conflict and prevents undue anxiety.

       Recognise limitations and seek assistance where necessary.

       Attend and contribute to appropriate meetings.

       Accept constructive advice when appropriate.

       Report all incidents immediately, which may adversely affect a patient, colleague or the Blackrock Clinic.

4.     GENERAL EXPECTATIONS

       Support the philosophy, objectives and goals of Blackrock Clinic

       Observe the appropriate lines of authority

       Maintain strict confidentiality regarding all patients and the activities of Blackrock Clinic

       Demonstrate flexibility to changing work practises and by assisting in all areas of the hospital/clinic as required

       Participate in developing and providing quality care within Blackrock Clinic

       Assist in orientation of new personnel

       Continue to develop personal knowledge and skills and seeks outside educational opportunities

       Present a professional appearance and conform to the dress, hygiene and infection control policies of the Clinic

       Is always punctual on duty

5.     COMPETENTICES

Achieving

       'Owns' the strategy: takes personal responsibility for getting done what needs to be done

       Deals with problems quickly and directly; doesn't let them fester

       Volunteers for tough assignments and projects

       Finds opportunities to improve ways of working or outputs

       Finds out what customers (internal or external) really want

       Resolves customer service problems promptly

       Perseveres with extra effort to reach objectives when progress is blocked

       Comes up with proposals and suggestions to enhance the performance of the unit

       Sets clear, measurable objectives and time-scales for self and others

       Clarifies how individual roles contribute to achieving business goals

       Prioritises work and activities for oneself and/or others

       Allocates time and resources needed for activities

       Adapts plans to accommodate changing circumstances

       Specifies actions to be taken in response to identified issues and problems

       Deals calmly and effectively with crises, unexpected or stress-provoking situations

       Displays stamina in pursuing goals and objectives

       Works systematically and according to plan in response to tight deadlines

Leading

       Makes people feel that they are part of a team by emphasising common business goals and sharing successes

       Adapts personal style to suit the circumstances and people involved

       Shows recognition and appreciation to others for their contributions

       Conveys confidence to individuals in their ability to succeed

       Supports and encourages team members to overcome problems and challenges

       Takes personal responsibility for the consequences of own actions and decisions

       Conveys confidence in own ability, decisions and actions

       Assigns responsibilities and tasks to staff in line with their abilities and interests

       Provides sufficient support to staff carrying out delegated tasks

       Shares expertise and experience, even where there may be little personal gain

       Builds people's confidence in their ability to succeed

       Gives honest feedback in a non-punitive manner to guide development

       Finds out subordinates' development needs and career goals

       Behaves in a manner consistent with the organisation's values and promotes the organisation's interests even where personal interests are challenged

       Sets an example to others through commitment to high personal standards and organisational goals

       Gives recognition - makes people feel their contributions matter

       Sets an example to others through commitment to high standards

       Seeks and probes others' points of view - generates involvement

Relating

       Persuading: designs arguments to appeal to others' interests and concerns, pointing out the benefits for them

       Keeps people informed and up-to-date through regular, informal contact and meetings

       Encourages two-way communication - avoids 'put-downs' and destructive criticism

       Presents information in a structured, systematic manner that is easy to follow

       Knows how the organisation works, both formally and informally

       Recognises what is feasible in the organisation and what is unacceptable

       Secures the support of key decision makers for plans and proposals

       Concedes own viewpoint in the interests of team goals

       Works co-operatively with others from various functions and backgrounds

       Being readily approachable and available to others

       Listens to others and clarifies issues before proposing solutions

       Sees things from other people's points of view

       Handles confidential personal information with respect and integrity

       Delivers what has been promised

       Behaves in a way that is consistent with what he/she says - 'walks the talk'

       Accepts feedback from others without defensiveness

       Abides by standards and principles, even when inconvenient or disadvantageous

       Encourages and accepts points of view that differ from his/her own

       Treats colleagues fairly, regardless of their cultural background, gender or lifestyle

        Draws on the diverse skills and talents of others, of all levels

Understanding

       Evaluates arguments critically, weighing up the pro's and con's

       Links information from different sources to identify patterns, trends and solutions

       Investigates causes of problems systematically and logically

       Recognises limitations of available data; spotting assumptions and risks

       Evaluates when it is appropriate to refer decisions upwards

       Draws on past experience to anticipate where problems are likely to arise

       Copes with ambiguities: does not demand certainty in data to make decisions about approach to adopt

       Knows who or where to go to get information

       Brings together data from many sources to understand the broad picture

       Recognises the wider impact and significance of own decisions and actions

       Ensures that documentation is accurate and up-to-date

       Uses correct grammar, spelling and punctuation

       Experiments with different approaches to find solutions

This job description indicates the main responsibilities of the post and is subject to periodic revision and amendment with the post holder