Medical Claims Asses....
Medical Claims Assessor - retrospective review - Allianz Partners
Posted on :
31-01-2024
Employer Active
1 Vacancy
Job Alert
You will be updated with latest job alerts via emailValid email field required
Send jobs
Job Alert
You will be updated with latest job alerts via emailValid email field required
Send jobs
Job Description
Req ID : 2487128
MAIN TASKS
Evaluates medical claims/invoices from the technical and medical perspectives as per policy terms and conditions.
Apply the claims submission procedure regarding copayment calculation penalty calculation and ensure that submission timeline and process are followed.
Ensures that insurance claims information is entered into the system correctly to ensure accurate processing and timely payment.
Ensures that providers fees and service items charges coincide with their existing contract price list with Nextcare.
Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.
Screens claim documents and process claim adjustment.
Ensures Payment Orders are properly created and forwarded accordingly for final documentation and filing.
Ensures adaptability in various workrelated tasks to be able to facilitate a multitasking role.
Ensures that high quality standard of work performance is achieved at all times.
Maintains daily productivity targets and service levels.
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 REQUIREMENTS:
Customer & Market Excellence:
- Strive for excellence at every touch point with the customer
- Foster stateofart 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 inclusivenes
- Act transparently and promote corporate social responsibility.
Minimum Requirements:
- Bachelors of Medicine ( MBBS ) or Pharmacy.
- 2 years Medical Practical Experience (reputable insurance provider broker or a TPA experience a plus).
- Physically fit to carry out duties.
- Certified Medical Code
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel Word Outlook PowerPoint) and general internet navigation and research skills
39937 Customer Services & Claims Professional NonExecutive Allianz Partners FullTime Permanent
Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees their ambitions dreams and challenges is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore to grow and shape a better future for our customers.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work no matter where you are from what you look like who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background age gender nationality religion disability or sexual orientation.
Join us. Lets care for tomorrow.
Note: Diversity of minds is an integral part of Allianz company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functi
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work no matter where you are from what you look like who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background age gender nationality religion disability or sexual orientation.
Join us. Lets care for tomorrow.
Note: Diversity of minds is an integral part of Allianz company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functi
Job Level:
Professional
Location:
Dubai AE
Area of Expertise:
Customer Services & Claims
Unit:
Allianz Partners
Employing Entity:
NEXTCARE Claims Management LLC
Job Type:
FullTime
Remote Job:
Not applicable
Employment Type:
Permanent
ID:
39937
Position Cluster:
NonExecutive
More jobs on
Employment Type
Full Time
Report This Job
Disclaimer: Drjobs.ae is only a platform that connects job seekers and employers. Applicants are advised to conduct their own independent research into the credentials of the prospective employer.We always make certain that our clients do not endorse any request for money payments, thus we advise against sharing any personal or bank-related information with any third party. If you suspect fraud or malpractice, please contact us via contact us page.
