Claims Management-Processor

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 customers.
Summary:

Evaluate complex data entry, clerical, and accounting tasks involved in the
preparation and processing of patient insurance claims. The role requires
supervision of the releasing team with regards to productivity and efficiency.
There will be the need to evaluate complex data entry, clerical, and
accounting tasks involved in the preparation and processing of patient
insurance claims.

Main Tasks:

• Ensure that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.


• Ensure that provider's fees and service items charges coincide with their existing contract price list with Nextcare.


• Ensure the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.


• Compare data on claims applications.


• Screen claim documents and process claim adjustment.


• Ensure Payment Orders are properly created and forwarded accordingly for final documentation and filing.


• Ensure adaptability in various work-related tasks to be able to facilitate a multi-tasking role.


• Ensure that high quality standard of work performance is achieved at all times.

Filing/Monitoring:

• Stand as a reference person for information on inquiries concerning claims processing procedures.


• Monitor correct application of beneficiary share accordingly on service items billed.


• Make sure that claims are properly audited of all data entered with accurate medical claims details.


• Note all discrepancies during the course of the system process are properly forwards and notifies to immediate supervisors.


• Provide requisition of office supplies for Individual and Team requirement.

Other Duties
* Researche claims as needed
* Obtain and audit medical records to compute and record patient charges.
* Perform other related duties incidental to the work described herein.
Minimum Requirements:

• Bachelor's Degree; Paramedical background preferred.


• ‎2+ years filing/documentation experience. Experience within the Health Care Industry, TPA's, insurance companies, Hospitals, Medical Centers is a plus.


• Physically fit to carry out duties.


• 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.