- Revision of all services/procedures prices for our contracted providers globally.- Analyzing price lists and agreements.- Evaluate agreed price lists globally for internal project. - Inspecting claims overcharges/over-utilization.- Ensure that providers are charging Bupa Global with the agreed pricing.- Claims investigations.- Resolve Europe providers queries regarding recoups.- Handle Bupa UK Providers Contract Compliance Queries

- Approving/rejecting all requests to authorize treatment (out-patient and In-patient requests)before any surgery or procedure.- Deal and evaluate claims of members and providers.- Deal with members’ and brokers telephone enquiries, evaluate the situation and apply business criteria and detailed knowledge of Bupa Global products to make appropriate decisions.- Apply changes to existing memberships according to Bupa policies and processes- Deal with billing inquiries.- Deal with providers that may have any queries related to their dealings with Bupa Global or on behalf of their clients.- Coordinate with Service Partners to set medical treatment appointments for members seeking treatment internationally.

- Revise claims medically and as per member's policy to decide any approval or rejection- Detecting fraud invoices- Handling inpatient/outpatient claims

- Respond to prior approvals requests with approval/rejection based upon the case.- Negotiate the cases with the health care providers (hospitals, pharmacies, lab, scans, PT centers...) - Being up-to-date with policies and table of benefits.- Answering clients inquiries regarding medical card benefits, information and network .- Advise on recommended actions based upon good medical practices.

- Preparing prescription using correct doses. - Listening to customer needs and questions. - Maintaining challenging atmosphere within staff. - Dispense medications through various medical insurance companies and TPA .