Claims Management Officer

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 a number of well-known customer 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 organisations (IGOs), non-governmental organisations (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.
* Main Tasks :
* Consistently checks and tracks claims received from providers which includes the following responsibilities:
* Checks claim submission for proper completion.
* Ensures that standard format for submission is followed such as general statement of account and detailed statement of account.
* Adheres to initial check of received physical claims count VS the listed in the statement
* Ensures feedback within set specified time for any corrections, missing information, and any standard format not being followed.
* Batching the received claims as per our standards and hand over physical claims to Retrospective team.
* Ensures proper documentation, feedback, and endorsement on the following:
* In case of missing information on the claim and standard format of submission are not followed, tries to communicate directly with the provider and if not reached report the case to provider OPS asking for support.
* Claims with incomplete administrative information to be returned to the provider.
* Providers not created on TATSH to be directed to MPM team for creation
* Attention to detail and ability to multitask.
* Behavioral requirments:
* Attention to detail and ability to multitask.
* Ability to work well with all levels of internal management and staff, as well as outside client and vendors.
* Demonstrable commitment to producing output-based results.
* Excellent team player.
* Organizational and time-management skills.
* Minimium Requirments :
* Bachelor's Degree of Science
* From ‎0 to ‎2 years management experience within Healthcare Industry (TPA, Insurance Companies, Hospitals, Medical Centers or Pharmacies).
* Physically fit to carry out duties
* Legally permitted to work in the country of operations.
* Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

Job Level:
Entry Level
Location:
EG
Available until:
‎30/‎05/‎2023
Area of Expertise:
Customer Services & Claims
Unit:
Allianz Partners
Employing Entity:
Nextcare Egypt
Job Type:
Full-Time
Remote Job:
Not applicable
Employment Type:
Permanent
ID:
‎26642