Claims Processing Officer
Cairo, EG
Key responsibilities/What you do:
- Audit and process all types of providers’ bills.
- Examine claim documents thoroughly.
- Ensure correct pricing is applied before processing bills in TATSH.
- Handle claim adjustments.
- Utilize AI-based screening tools to verify accurate entry of insurance claim information, ensuring precise processing and timely payment.
- Verify all required fields in TATSH, such as visa notes, precertification center notes, contract notes, policy files, medical files, and faxes, to guarantee accurate processing.
- Process and record invoice details in TATSH according to policy terms, product type, TOB, and information from medical auditors, providers, and precertification officers.
- Follow up daily on pending claims or issues with relevant departments until resolved.
- Notify the Network department upon receiving jumbo claims to secure special discounts from providers.
- Report in writing to the Network department any deviations from agreed tariffs by providers.
- Inform the Team Leader or Manager in writing about complaints related to payers’ or providers’ invoices received by the Claims Processing department.
- Communicate in writing to the Team Leader or Manager any requests or information needed from other departments.
- Adhere strictly to the Department’s internal procedures.
- Maintain confidentiality and proper management of insured member data, system information, policies, and medical records.
- Perform any other duties assigned by the Direct Manage
Key requirements/What you bring:
- Education: Pharmacy Degree.
- Experience: Minimum 2 years in the Health Care Industry, including TPA’s, insurance companies, hospitals, or medical centers.
- Strong commitment to delivering results.
- Ability to meet deadlines consistently.
- Excellent teamwork skills.
- Outstanding communication and organizational abilities.
- Flexibility to work shifts.
- Willingness to work overtime when necessary.
- Basic proficiency in MS Office applications.
Key benefits/What we offer:
Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, 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 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.
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. Let's 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 functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group
