Medical Claims Senior Officer

؜ - ؜مصر ؜ -

Job details

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:


Senior claims officer provides quality service to clients, promptly and
effectively assesses and process claims and approval according to operations
set standards.
Senior claims officer is also responsible for team success by agreeing,
implementing and monitoring individual and team objectives and targets
ensuring company policies and procedures are adhered to.


Main Tasks:



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

  • Channels claims officers in handling difficult medical cases and optimize the quality and quantity output.

  • Checks particular treatment plan is necessary for the patient.

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

  • Provides clients an understanding of any declined medical claims.

  • Maintains daily productivity targets and service levels.

  • Manages routine daily claims administration work.

  • Coordinates work flow & meet deadlines.


  • Provides on job training/support to team members as necessary.
    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:
EG
Available until:
‎28/‎02/‎2023
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:
‎21798

Job Summary

  • Advertiser: Allianz
  • Announcement date: 24/01/2023
  • Type of employment: -
  • Experience level: -
  • Educational level: -
  • Salary: -
  • Phone number: -

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