Medical claims Officer - MCC

Over view
The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process OP claims according to operations set standards

 what you do

Key responsbilities

Manages routine daily claims administration work. 
Coordinates work flow & meet deadlines. 
Evaluates OP claims with regards to eligibility. 
Apply nextcare cost containment protocols for OP claims at the retrospective review level
Attends calls and e-mails from insurance companies, clients, and providers.
Makes suggestions to improve service.
Increases efficiency, minimizes errors and administration time. 

Behavioural requirments

Organizational & time management skills.
Excellent team player.
Ability to work well with all levels of internal management and staff, as well as outside clients and users.
Ability to demonstrate sound work ethics. 
Show flexibility with excellent interpersonal skills.
The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.
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.
The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
Utilize AI-enhanced communication tools to communicate sensitively and effectively with claims and other departments, maintaining confidentiality,Exercise initiative and use AI tools to work flexibly under pressure and tight deadlines.

what you bring

Key requirments

Bachelor’s of Pharmacy / Dentistry / Medicine / Nursing / Physiotherapist / Paramedics
Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level
Physically fit to carry out duties.
Certified Medical Coder [Preferable]
Legally permitted to work in the country of operations.
Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills

Certified Medical Coder is preferable, with familiarity in AI-driven coding tools being beneficial.

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.

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