Claims Processing Officer

Job description

The Claims Processing Officer evaluates and audits providers’ bills and processes them on the system. He / She performs scan for detection of missing documents and ensures that medical report, prescription /tests /invoices are coherent.

 

What you do

•Audit and process all kinds of providers’ bills.
•Screen claim documents
•Ensure that proper pricing is applied for bills before processing them in TATSH.
•Process claim adjustment.
•Ensure that insurance claims information is entered into the system correctly, to ensure accurate processing and timely delivery to payers.
•In charge of checking all required fields on TATSH to ensure accurate processing such as visa notes, precertification center notes, contract notes, policy file, medical file, faxes, etc.
•In charge of processing and recording details of the invoice on TATSH in accordance with policy terms and conditions, product, TOB, and other information as relayed by the medical auditor and provider and/or the other relevant details as gathered by the Precertification officer.
•Daily follow up on pending claims/issues with concerned departments until problem resolution.
•Meet goals set forth by company.
•Inform Network department when receiving a jumbo claim as per agreed procedure in order to obtain a special discount from providers.
•In charge of reporting in writing to the Network department regarding any deviation from the provider concerning the application of the agreed tariff
•In charge of reporting in writing to the Team Leader/Manager regarding complaints received by the Claims Processing department and relating to     payers/providers invoices
•In charge of reporting in writing to the Team Leader/Manager regarding any information/task required from other departments
•Follow and apply the internal procedures of the Department
•Responsible and accountable for the confidential, proper administration of insured member data as well as system, policy and medical information
•Any other duties as requested by the Direct Manager
 
What you bring

•Education: Baccalaureate Degree or equivalent
•Experience: 2+ years experience within the Health Care Industry (TPA’s, Insurance companies, Hospitals, Medical Centers)
•Demonstrate commitment to producing output base results
•Ability to respect deadlines
•Excellent team player.
•Excellent communication and organizing  skills
•Flexible and ability to work shift
•Willing to work overtime when requested.
•Basic knowledge of MS Office applications
 

What we offer:

Our employees play an integral part of our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being part of their journey. We are there to empower you and your professional and personal goals and for that reason here are some of our benefits:

 

·  Dynamic and Multinational working environment
·  Trainings and programs dedicated to Learning and Development (e.g. free accesss to LinkedIn Learning)
·  A wide range of employee benefits such as performance bonus, health insurance.
·  Open company culture, flexibility of working hours, giving you a hybrid working environment. 
·  Modern Offices
 

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.