High Risk Claims Consultant – Bupa Global (Fixed Term)
Location: Bupa Victory House, Trafalgar Place, Trafalgar Street, Brighton, UK, BN1 4FY
Hours: Full time – 35 hours per week
Contract: Fixed Term – until 1 April 2025
Salary: From £25,500 per annum (dependent on experience and qualifications)
Working Pattern: Hybrid – minimum one day per week in office
Bupa Global is the international health insurance division of Bupa, offering premium coverage that allows customers to access healthcare worldwide, whether at home, studying, living, travelling or working abroad.
Responsibilities
Your role is customer‑facing and involves balancing cost containment with accurate, fair outcomes for customers and providers. You will handle high‑risk claims, ensuring timely resolution and compliance while identifying savings and fraud opportunities.
* Take end‑to‑end ownership of all customer/provider claim enquiries; case‑manage queries through to resolution.
* Accurately adjudicate high‑value claims, both referred and submitted directly, maximizing savings where appropriate.
* Work high‑risk referrals in Swan and shift referrals, identifying savings and potential fraudulent behaviour.
* Participate in stakeholder meetings and collaborate with Service Managers, Health Care Management and Continuous Improvement partners.
* Record savings accurately in the relevant spreadsheets.
* Maintain and update customer records in the management system, ensuring accuracy after every contact.
* Comply with all regulatory and governance requirements, including FCA and Treating Customers Fairly.
Benefits
* 25 days holiday per year, pro‑rated to contract.
* Access to a range of services supporting physical and mental wellbeing.
* Fixed‑term benefits allowance.
* Confidential employee assistance programme.
* Workplace pension.
* Online discounts on everyday shopping, entertainment, dining out and more.
Why Bupa?
As a Level 2 Disability‑Confident Employer, Bupa champions diversity and encourages applications from people with diverse backgrounds. We are committed to treating all applicants fairly and making reasonable adjustments during recruitment.
Time type: Full time | Job area: Administration | Locations: Victory House, Brighton
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