Medical Claims Assessor

Key responsibilities/What you do:

• 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 provider’s 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 work-related tasks to be able to facilitate a multi-tasking role.
• Ensures that high quality standard of work performance is achieved at all times.
• Maintains daily productivity targets and service levels.

AI READINESS Work effectively in an environment shaped by artificialintelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use

Key requirements/What you bring:

• Bachelor’s degree.
• 2+ years 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

How we hire Allianz Partners does not accept unsolicited CV’s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered

Key benefits/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

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 to shape a better future for our customers and the world   around us.

At Allianz, we stand for unity: we believe that a united world is a   more prosperous world, and we are dedicated to consistently advocating for   equal opportunities for all. And the foundation for this is our inclusive   workplace, where people and performance both matter, and nurtures a culture   grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural   background, age, gender, nationality, religion, social class, disability or   sexual orientation, or any other characteristics protected under applicable   local laws and regulations.

At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector. 

Great to have you on board. Let's care for tomorrow