We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has a number of well-known customer facing brands such as Allianz Care, Nextcare and Medi24.
The International Health line of business provides international health, life and disability insurance and services, reinsurance and administration services to a wide range of customers. These include multinational companies, intergovernmental organisations (IGOs), non-governmental organisations (NGOs), private individuals, families and students. Our mission is to ensure that customers have access to quality healthcare through our support, care and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment and value for our customer.
Summary:
Senior claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.
Senior claims officer is also responsible for team success by agreeing, implementing and monitoring individual and team objectives and targets ensuring company policies and procedures are adhered to.
Main Tasks:
•Evaluates medical claims from the technical and medical perspectives, and ensures if claims are valid as per insurance policy terms and conditions.
•Channels claims officers in handling difficult medical cases, examine and authorizes claims evaluated by them, and optimizes the quality and quantity output.
•Verifies if the requested treatment plan is necessary for the patient by consulting other doctors and reviewing international guidelines.
•Refers to expert doctors for a second opinion for insurance claims where there is a doubt about the treatment plan.
•Approves/declines medical claims according to insurance policy terms and conditions.
•Provides clients an understanding of any declined medical insurance claims.
•Maintains daily productivity targets and service levels.
•Manages routine daily insurance claims administration work.
•Coordinates work flow and meet deadlines.
•Provides on job training/support to team members as necessary.
25309 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
Minimum Requirements:
•Education: Bachelor’s of Medicine (MBBS)
•Must have DOH,HAAD or MOH Licence
•Experience: 2+ years 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 skills
DETAILS TO REGISTER FOR THIS JOB:
https://careers.allianz.com/job/Medical-Claims-Senior-Claims-Officer/931120201/
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