Precertification Officer

Job description

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 several well-known customers 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 organizations (IGOs), non-governmental organizations (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

Precertification officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.

Main Tasks

•Assesses approval of medical approvals as well as policy use.
•Checks particular treatment plan is necessary for the patient.
•Inputs verbal and written claims approvals regularly.
•Decides approvals as per policy conditions.
•Assess high cost claims and provide decision on high cost and complicated cases.
•Provides clear feedback on queries from call Centre team.
•Provides clients an understanding of any declined medical claims.
•Coordinates work flow & meet deadlines.
•Evaluates claims with regards to eligibility.
 
Behavioral Requirements
•Strong verbal and written communication skills.
•Show flexibility, excellent interpersonal skills.
•Team Player.
•Attention to detail and quality.
•Ability to work well with all levels of internal management and staff, as well as outside clients and users.  
•Ability to train other staff.
•The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need
for confidentiality.
•Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be
able to work effectively with others.
•The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines
 
Behavioral Competency

Customer & Market Excellence:

•Strive for excellence at every touch point with the customer
•Foster state-of-art  technical/operational knowledge and strive for continuous simplification
•Be the benchmark

Collaborative Leadership:

•Empower the team and provide purpose and direction
•Develop people, provide  feedback and care to employee wellbeing
•Collaborate and exchange best practice.

Entrepreneurship:

•Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
•Take ownership and responsibility
•Embrace innovation and a culture that allows to make decisions without fear of retribution.

Trust:

•Act with integrity, honor commitments, tell the truth
•Foster diversity and inclusiveness Act transparently and promote corporate social responsibility.

Minimum Requirements

•Bachelor’s of MedicinePharmacy.
•2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
•Legally permitted to work in the country of operations.
•Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.