The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process OP claims according to operations set standards.
Key Responsibilities/What You Do
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.
- Evaluates OP claims with regards to eligibility.
- Apply nextcare cost containment protocols for OP claims at the retrospective review level
- Attends calls and e-mails from insurance companies, clients, and providers.
- Makes suggestions to improve service.
- Increases efficiency, minimizes errors and administration time.
Key Requirements/What You Bring
- Bachelor's of Medicine.
- Medical Practical Experience (reputable insurance provider, broker or a TPA experience is a plus) OR Entry Level
- Physically fit to carry out duties.
- Certified Medical Coder [Preferable]
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and generalinternet navigation and research skills
- Organizational & time management skills.
- Excellent team player.
- Ability to work well with all levels of internal management and staff, aswell as outside clients and users.
- Ability to demonstrate sound work ethics.
- Show flexibility with excellent interpersonal skills.
- The ability to communicate sensitively and effectively with claimsdepartment and other departments having regard for the strict need forconfidentiality.
- To be capable of responding diplomatically to pressures and problemsshowing a calm approach to working towards deadlines and alwaysable to show an innovative and creative approach to work.
- The ability to exercise initiatives and be able to work flexibly underpressure and to tight deadlines.
- Experience of working with senior managers and understanding thenecessity to act in a pleasant and courteous manner and to be able towork effectively with others.
Key Benefits/What We Offer
Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.
We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.
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 shape a better future for our customers.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation. Join us. Let's care for tomorrow.Note: Diversity of minds is an integral part of Allianz company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group
At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners position as a leader in the insurance sector.
