Medical Claims Admin

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.
Summary :
* The Medical Claims - Admin (Field Control Unit) will represent Nextcare at the provider location and shall be responsible to provide quality service to clients, promptly and effectively. The incumbent would liaise with Nextcare Operations on a case to case basis, whenever required.
Main Tasks :
* Liaise with the relevant unit of the Medical Claims (Nextcare) to take second opinions on cases when required and control average length of stay.
* Cost containment for Inpatient cases resulting in saving amount, ensuring that all processes are completed and closed within stipulated time after discharge.
* Provide assistance to Nextcare Customer Service for complaints or queries related to VIP members.
* Manage routine daily claims administration work at the provider location.
* Coordinate work flow & meet deadlines as per Nextcare KPIs.
* Ensure up-to-date, regular data entry into TATSHBO, FMS/EMS, and PULSE e-authorization as per prescribed procedure
* Increasing efficiency, minimizing errors and administration time.
Behavioral Requirements:
* Establish and maintain good customer relationship and build trust and respect by consistently meeting and exceeding expectations.
* Able to communicate clearly and concisely, verbally and in writing.
* Strong medical knowledge and ability to take informed decisions on medical cases.
* Maintain good interpersonal skills and ability to be a good team player.
* Requires strong computer skills.
* Attention to detail and quality
* Strong financial acumen.
* Demonstrates knowledge and understanding of organizational policies, procedures, and systems.
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Minimum Requirements :
* Customer service experience in a the medical field
* Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus)
* Knowledge of overall insurance industry practices is a plus; the ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
* Legally permitted to work within the country.
* Fluency in Microsoft Office applications (including Word, Power Point & Excel and Outlook) and general Internet navigation and research skills Show flexibility, excellent interpersonal skills, project coordination experience.

Job Level:
Professional
Location:
EG
Available until:
‎22/‎03/‎2023
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:
‎23198