Claims Management Processing Officer (CIVP Contract)

Job description

Job Overview:

The Claims Management – Processor, evaluate more complex data entry, clerical, and accounting tasks involved in the preparation and processing of patient insurance claims. Supervises releasing team with regards to productivity and efficiency.

What you do:

Responsibilities will include, but are not limited to, the following:

·  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 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 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.
·  Provide requisition of office supplies for Individual and Team requirement.

Other Duties

·  Researches claims as needed
·  Obtains and audit medical records to compute and record patient charges.
·  Performs other related duties incidental to the work described herein.

 

 

What you bring:

To be successful in this position you will need to have the following skills/ experience:

·  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.
·  Sound knowledge of Project Management principles and tools.
·  Accurately forecasts revenue, profitability, margins, bill rates and utilization.
·  Legally permitted to work in the country of operations.
·  Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

 

 

 

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.

71356 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent

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. 
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.