Claims Officer
Tunis, تونس
Job description
Responsible to review high-cost Reimbursement Claims, direct claims /Reimbursement Claims coverage ,manage medical evaluations, errors and claims turn-around-time and processors queries to achieve quality decisions and evaluations.
what you do
• Review and handle claims according to the established standard procedure.
• Support the team and departmental productivity goals to meet the agreed upon Service Level Agreement (SLA) and deliver exceptional customer service
• Provide accurate and professional responses to client inquiries, and if needed, collaborate with other departments to ensure prompt and efficient resolution.
• Maintain accurate and up-to-date records of all claims activities.
• Ensure compliance with all relevant regulations, company policies, and industry standards.
• Identify potential fraud or discrepancies in claims and take appropriate actions.
• Collaborate with the risk management team to mitigate risks associated with claims processing.
• Implement and maintain robust quality control measures.
• Other Ad hoc duties as required
What you bring
• Bachelor’s degree in any Medical Field, Insurance, or a related field is required.
• 1-2 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA/Insurance roles
• Proficiency in MS Office
• Knowledge of insurance policies, claims procedures, and relevant regulations.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Proficiency in claims management software and data analysis tools.
• High level of accuracy and attention to detail.
• Ability to work independently and as part of a team.
• Legally permitted to work in the country of operations.
• Hybrid working option available as per business requirements.
What we offer
Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs and 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 a 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.
81349 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent