Medical Claims Officer (Strong Medical Background Required)

<p><b>SUMMARY </b></p><p>The Medical Claims Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.</p><p> </p><p><b>MAIN TASKS</b></p><p> </p><p>•Manages routine daily claims administration work.</p><p>•Coordinates work flow & meet deadlines.</p><p>•Evaluates claims with regards to eligibility.</p><p>•Takes decisions on high cost and complicated cases based on standard operating procedures.</p><p>•Handles International Preauthorization cases as required.</p><p>•Attends calls and e-mails from insurance companies, clients, and providers.</p><p>•Coordinates with international providers for direct billing.</p><p>•Makes suggestions to improve service.</p><p>•Increases efficiency, minimizes errors and administration time.</p><p> </p><p><b>BEHAVIORAL REQUIREMENTS</b></p><p>•Organizational & time management skills.</p><p>•Excellent team player.</p><p>•Ability to work well with all levels of internal management and staff, as well as outside clients and users.</p><p>•Ability to demonstrate sound work ethics.</p><p>•Show flexibility with excellent interpersonal skills.</p><p>•The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.</p><p>•To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.</p><p>•The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.</p><p>•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.</p><p> </p><p><b>BEHAVIORAL COMPETENCY </b></p><p><b>Customer & Market Excellence:</b></p><p>•Strive for excellence at every touch point with the customer</p><p>•Foster state-of-art  technical/operational knowledge and strive for continuous simplification</p><p>•Be the benchmark</p><p><b>Collaborative Leadership:</b></p><p>•Empower the team and provide purpose and direction</p><p>•Develop people, provide  feedback and care to employee wellbeing</p><p>•Collaborate and exchange best practice.</p><p><b>Entrepreneurship:</b></p><p>•Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure</p><p>•Take ownership and responsibility</p><p>•Embrace innovation and a culture that allows to make decisions without fear of retribution.</p><p><b>Trust:</b></p><p>•Act with integrity, honor commitments, tell the truth</p><p>•Foster diversity and inclusiveness</p><p>•Act transparently and promote corporate social responsibility. </p><p> </p><p><b>MINIMUM REQUIREMENTS</b></p><p>•Bachelor’s of Medicine (MBBS) only.</p><p>•Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).</p><p>•Physically fit to carry out duties.</p><p>•Legally permitted to work in the country of operations.</p><p>•Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills</p><p> </p><p> </p><p>44265 | Operations | Professional | [[custPositionClusterCSB]] | Allianz Partners | Full-Time | Permanent</p><table style="width:100%"><tbody><tr></tr></tbody></table>