Sr. Specialist - AAGI A&H Claims Payment CPU2

Job description

The position is responsible to assess the claim both approve and reject base on their authority, monitoring pending claim, produce any claim report (Monthly report, Insurance shortfall report, Adhoc report etc.), claim quality checking to ensure that they are performed accurately according to the processes and procedures, and in timely manner.

Job Responsibilities :

• Provider/member claims assessment base on their authority.
• Monitor/review/follow-up pending claim cases in timely manner.
• Produce claim reports: 
   Claim monthly reports
   Insurance claim shortfall report 
   Adhoc reports 
   Etc.
• Claim quality checking.
• To coordinate with relevant departments if clarifications/inquiries are required, such as Finance, CS, Sale, UW, etc.
• Support other team when needed such as FAX claims assessment, review customer medical history etc.
• Other assignment

Qualifications 

• Bachelor’s or Master’s Degree in Nursing, Business of Sciences (Medical Technology), or other related fiel

• Minimum 2 Years of experience in Claims Assessor  or other related fields in insurance industr

Any AI-future skills e.g., ChatGPT, or CoPilot 365, will be an advantage.

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.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Join us. Let's care for tomorrow.