Medical Claims Officer

؜ - ؜Dubai ؜ -
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Job details

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


Main Tasks



  • Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions.

  • Checks particular treatment plan is necessary for the patient.

  • Refers for a second opinion for cases where there is doubt in treatment plan.

  • Maintains daily productivity targets and service levels.

  • Manages routine daily claims administration work.

  • Coordinates work flow & meet deadlines.
    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

  • Education: Bachelor's of Medicine (MBBS)

  • Experience: ‎2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus)

  • 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:
Professional
Location:
Dubai, AE
Area of Expertise:
Operations
Unit:
Allianz Partners
Employing Entity:
NEXTCARE Claims Management LLC
Job Type:
Full-Time
Remote Job:
Hybrid working
Employment Type:
Permanent
ID:
‎36833

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Job Summary

  • Advertiser: Allianz
  • Announcement date: 05/12/2023
  • Type of employment: -
  • Experience level: -
  • Educational level: -
  • Job location: Dubai
  • Salary: -
  • Phone number: -

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