Who are Mapfre?
MAPFRE is a global insurer present in 49 countries on all five continents. It is Spanish insurance market leader and first multinational insurance group in Latin America, ranking among the top ten in Europe by premium volumes.
MAPFRE employs more than 37,000 people and has more than 27 million customers worldwide.
Why work for Mapfre?
Mapfre has achieved great things so far and the business has grown from strength to strength. We still have even bigger ambitions, meaning that there are many exciting opportunities in the future. Bristol is our UK Headquarters and is growing rapidly in size; we have recently relocated our Southend Travel Claims business to Bristol which has created many jobs and lots of opportunities.
We have many employees who have been with the company for many years; a testament to our culture of treating staff fairly and providing a happy yet challenging working environment where training, personal growth and promotion are encouraged and supported.
Purpose of the role:
To provide medical management services on emergency assistance cases, adhering to best practices within the Medical Panel. To review medical cases based on information received and by following established procedures, ensure that clear and accurate advice is provided to the Operations team and to external providers of medical escort services
Duties to include but are not limited to:
- Triage: review initial diagnosis and determine patient requirements (urgency, critical care, location etc.)
- Authorise medical tests, surgery and hospitalisation, such as MRI and CAT scans in simple cases
- Working closely with the Operations team:
- Offer advice and opinion on best course of treatment of the condition suffered in simple cases, taking into account the insurance policy coverage, pre-existing conditions etc.
- Refer cases to external clinical advisers where appropriate
- Review medical information from providers (medical report and medical contact).
- Follow up patients’ progress throughout the course of treatment/hospitalisation to ensure appropriate care and quality services are provided, taking decisions in simple cases and referring to doctors where necessary.
- Assist in the organisation of medical evacuation and medical repatriations
- Advise on potential breaches of policy terms by requesting and reviewing PMH and medical declarations as appropriate
- Review potential fraudulent invoices (medical necessity and cost) to ensure the Company has not been overcharged or that the patient has not been overtreated.
- Ensure medical information is entered into the case management system
- Ensure that all regulatory guidelines are adhered to, for example Patient Confidentiality
- Adhere to the Company’s procedures in accordance with the FSA guidelines and TCF (treating the customer fairly).
- Compliance with the Data Protection Act 1998.
- Support Managers to manage the key risks within your department.
- Ensure that you conduct your role in accordance with AFC policy (to act honestly and with integrity) and to report any suspected incidents of fraud and corruption.
- Adherence with all Company Policies and Procedures, including Health & Safety, Equal Opportunities, Data Protection, Code of Conduct, Security, IT and Internal Control Financial Regulations.
- To undertake any other duty or responsibility that may reasonably be allocated by your Manager/Company’s Senior Management Team.
- Customer Focus
- Problem Solving
- Business Understanding
- Excellent customer service skills (good listener, clarity, assertiveness and calm down the customer)
- Power to persuade in communication
- Decision making
- Problem solving
- Ability to handle critical situations and provide simple solutions
- Ability to meet quality and service level standards
- Must have a nursing qualification such as RGN or SRN.
- Desirable: previous experience in field of travel insurance and aviation medicine
- Strong primary care medical knowledge and medical procedures
Other significant Role Requirements:
- Good numerical skills and computer literate.
- Excellent written communication skills.
- Good planning and organisation skills in order to meet timescales.
- Ability to identify problem issues and determine the appropriate course of action/redirection within department guidelines required to resolve issues.
- Ability to work as part of a team or on own initiative.
- A good understanding of FCA regulations and TCF (treating customers fairly).
Scope of Role:
- This position is within a 24hs/365 day centre.
- Hours - 37.5 hours per week
- Monday to Friday - shift between 8.00 and 20.00
- Saturday - 9.00 - 5.30
- Some flexibility may be required to meet future business needs.
Mapfre Pre-Employment Screening Process. Employment will be subject to satisfactory clearance on background checks including Identification, Passport Validation, Finance, Qualification, Employment / Personal referencing.
Mapfre is an equal opportunities employer. Equality, diversity and fairness are at the heart of everything we do. We recognise the value of a truly diverse workforce and the contribution that every individual can make. In order to achieve and maintain excellence, we aim to create an environment that respects the diversity of staff and enables them to achieve their full potential.