Medical Claims Officer - Physicians only

Job description

The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process OP claims according to operations set standards.

Key requirements/What you bring:

• Bachelor’s of Medicine. 

• Medical Practical Experience (reputable insurance provider, broker or a TPA experience is a plus) OR Entry Level​

• Physically fit to carry out duties.​

• Certified Medical Coder [Preferable]

• Legally permitted to work in the country of operations.​

• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and generalinternet navigation and research skills​

• Organizational & time management skills.​

• Excellent team player.​

• Ability to work well with all levels of internal management and staff, aswell 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 claimsdepartment and other departments having regard for the strict need forconfidentiality.​

• To be capable of responding diplomatically to pressures and problemsshowing a calm approach to working towards deadlines and alwaysable to show an innovative and creative approach to work.​

• The ability to exercise initiatives and be able to work flexibly underpressure and to tight deadlines.​

• Experience of working with senior managers and understanding thenecessity to act in a pleasant and courteous manner and to be able towork effectively with others.​

Key responsibilities/What you do:

• Manages routine daily claims administration work. ​

• Coordinates work flow & meet deadlines. ​

• Evaluates OP claims with regards to eligibility. ​

• Apply nextcare cost containment protocols for OP claims at the retrospective review level​

• Attends calls and e-mails from insurance companies, clients, and providers.​

• Makes suggestions to improve service.​

• Increases efficiency, minimizes errors and administration time. 

AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.  

How we hire:

Allianz Partners does not accept unsolicited CV’s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered. 

Key benefits/What we offer:

Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners’ businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. 

At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.