The Claims Processing Officer Evaluate more complex data entry, clerical, and accounting tasks involved in the preparation and processing of patient insurance claims Co-ordinates with Tracking and releasing Teams for efficient claims management process.

Key Responsibilities/What You Do

Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.
Ensures that provider's fees and service items charges coincide with their existing contract price list with Nextcare.
Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.
Compares data on claims applications.
Screens claim documents and process claim adjustment.
Ensures Payment Orders are properly created and forwarded accordingly for final releasing, documentation and filing.
Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role.
Ensures that high quality standard of work performance is achieved at all times.

Filing/Monitoring

Stands as a reference person for information on inquiries concerning claims processing procedures.
Monitors correct application of beneficiary share accordingly on service items billed.
Makes sure that claims are properly technically audited of all data entered with accurate medical claims details.
Notes all discrepancies during the course of the system process are properly forwards and notifies to immediate supervisors.
Researches claims as needed
Performs other related duties incidental to the work described herein.
AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

Key Requirements/What You Bring

Bachelor's Degree; Paramedical background preferred.
2+ years filing/documentation experience. Experience within the Health Care Industry, TPA's, insurance companies, Hospitals, Medical Centers is a plus.
Physically fit to carry out duties.
Legally permitted to work in the country of operations. Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
Basic proficiency in MS Office applications

How We Hire

Agency Statement Allianz Partners does not accept unsolicited CV's or approaches from agencies. We only work with partners on our approved supplier list, undercontract. Any unsolicited submission will not be considered

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Great to have you on board. Let's care for tomorrow.

Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.

Claims Processing Agent