Summary
The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.
MAIN TASKS
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.
- Evaluates claims with regards to eligibility.
- Takes decisions on high cost and complicated cases based on standard operating procedures.
- Handles International Preauthorization cases as required.
- Attends calls and e-mails from insurance companies, clients, and providers.
- Coordinates with international providers for direct billing.
- Makes suggestions to improve service.
- Increases efficiency, minimizes errors and administration time.
Behavioral Requirements
- Organizational & time management skills.
- Excellent team player.
- Ability to work well with all levels of internal management and staff, as well 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 claims department and other departments having regard for the strict need for confidentiality.
- To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.
- The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
- Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others.
BEHAVIORAL COMPETENCY
Customer & Market Excellence:
- Strive for excellence at every touch point with the customer
- Foster state-of-art technical/operational knowledge and strive for continuous simplification
- Be the benchmark
Collaborative Leadership:
- Empower the team and provide purpose and direction
- Develop people, provide feedback and care to employee wellbeing
- Collaborate and exchange best practice.
Entrepreneurship:
- Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
- Take ownership and responsibility
- Embrace innovation and a culture that allows to make decisions without fear of retribution.
Trust:
- Act with integrity, honor commitments, tell the truth
- Foster diversity and inclusiveness
- Act transparently and promote corporate social responsibility.
46008 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
46008 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
Minimum Requirements
- Bachelors of Medicine (MBBS) and pharmacy
- Medical Practical Experience (reputable insurance provider, broker or a TPA experience 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 skil
