Claims Officer

Responsible to review high-cost Reimbursement Claims, direct claims /Reimbursement Claims coverage ,manage medical evaluations, errors and claims turn-around-time and processors queries to achieve quality decisions and evaluations.

what you do 

• Review and handle claims according to the established standard procedure.

• Support the team and departmental productivity goals to meet the agreed upon Service Level Agreement (SLA) and deliver exceptional customer service

• Provide accurate and professional responses to client inquiries, and if needed, collaborate with other departments to ensure prompt and efficient resolution.

• Maintain accurate and up-to-date records of all claims activities.

• Ensure compliance with all relevant regulations, company policies, and industry standards.

• Identify potential fraud or discrepancies in claims and take appropriate actions.

• Collaborate with the risk management team to mitigate risks associated with claims processing.

• Implement and maintain robust quality control measures.

• Other Ad hoc duties as required

What you bring

• Bachelor's degree in any Medical Field, Insurance, or a related field is required.

• 1-2 years' experience in a customer focused environment, ideally in clinical, paramedical roles or TPA/Insurance roles

• Proficiency in MS Office

• Knowledge of insurance policies, claims procedures, and relevant regulations.

• Strong analytical and problem-solving skills.

• Excellent communication and interpersonal skills.

• Proficiency in claims management software and data analysis tools.

• High level of accuracy and attention to detail.

• Ability to work independently and as part of a team.

• Legally permitted to work in the country of operations.

• Hybrid working option available as per business requirements.

​

​What we offer

Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs and ambitions, and we enjoy being a part of their journey. 

We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is a key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance. 

81349 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent