Customer Service Advisor – Member Support (Private Medical)

About the role

The Member Advisor will act as the primary point of contact for Healix members, helping them navigate their private medical insurance plans. You will coordinate treatment plans, liaise with clinicians and providers, and ensure members receive accurate medical information and timely access to services.

Key responsibilities

• Answer inbound calls from members, providers and clinicians regarding claims and treatment queries.
• Gather and verify medical evidence to support claims decisions and pre‑authorisation requests.
• Arrange appropriate care with medical teams or facilities and monitor ongoing treatment plans.
• Negotiate provider fees within Healix’s Reasonable and Customary fee framework to support cost containment.
• Maintain accurate records in the Case Management System, allocating documents to the correct cases.
• Assist case managers with high‑cost claims when required.

Required profile

• Excellent verbal and written English communication skills.
• Strong decision‑making ability and initiative.
• High attention to detail and ability to work under pressure.
• Team‑oriented yet capable of working independently.
• Good problem‑solving and analytical abilities.
• Commercial awareness and understanding of the private medical insurance sector (advantageous).

Required skills

• Customer service experience.
• Familiarity with medical claims handling processes.
• Proficiency in using a case management system.

What we offer

• Full‑time permanent position based in Esher.
• Competitive salary ranging from £26,000 to £28,000 per year.